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They are insufficient, as the systems these clinicians have been using have not been designed to manage the requirements of value-based care. The data pipelines, platforms, and workflows between clinical decisions and financial outcomes play a direct role in shaping ACO Performance<\/a>. When that infrastructure is established, ACOs are better equipped to improve performance across the rest of the contract year. Even highly capable care teams struggle to perform effectively when critical infrastructure gaps remain unresolved.<\/p>\n The disconnect between ACOs that are consistently meeting shared savings and those that do not nearly always has a common root cause: disconnected, delayed, and fragmented infrastructure.<\/p>\n The Infrastructure Barriers That Limit Long-Term ACO Performance<\/strong><\/p>\n These are not abstract risks. These are measurable gaps commonly found in underperforming ACOs, and they typically fall into two categories.<\/p>\n Structural Barriers: The Blind Spots<\/strong><\/p>\n These are the problems ACOs often don’t see until the intervention window has already closed.<\/p>\n Claims lag of 60–90 days:<\/strong> By the time data arrives, the patient has been admitted, discharged, and possibly readmitted. There’s nothing left to intervene on.<\/p>\n Misaligned risk scores:<\/strong> If HCC codes do not reflect actual patient complexity, benchmarks may fail to represent the expected cost burden accurately.<\/p>\n Unstable attribution:<\/strong> Patient panels shift constantly. Without dynamic tracking, care managers work off lists that no longer match reality.<\/p>\n Undetected high-cost patterns:<\/strong> Rising ER utilization, avoidable admissions, and specialist overuse may increase spending before care teams have time to intervene.<\/p>\n Operational Barriers:<\/strong> When Knowing Still Isn’t Enough<\/p>\n These hit even after a problem is correctly identified. The infrastructure slows down or fully blocks the response.<\/p>\n 10+ disconnected tools<\/strong>: The majority of ACOs operate on a system of EHRs, care platforms, and payer portals that do not exchange data in real-time.<\/p>\n Delayed intervention routing:<\/strong> When alerts take days to reach care managers and even longer to reach providers, the opportunity for timely intervention may already be lost.<\/p>\n Manual forecasting gaps:<\/strong> Manual forecasting methods often fail to align closely with CMS reconciliation results, limiting the ability to make timely financial adjustments.<\/p>\n No unified performance<\/strong> view<\/strong>: When quality measures, utilization data, and financial information exist in separate systems, leadership decisions are often based on incomplete information.<\/p>\n How Care Management Infrastructure Improves Long-Term ACO Performance<\/strong><\/p>\n Strong care management infrastructure changes the economics of how an ACO operates across every contract year.<\/p>\n Real-Time Data Shifts Costs from Reactive to Preventive<\/strong><\/p>\n When an ACO can see a rising cost signal days after it starts, it can intervene before hospitalization. That shift, repeated across hundreds of patients, compounds significantly over time. ACOs still waiting on claims data are spending money managing crises. ACOs with real-time data feeds can direct resources toward prevention rather than reacting after costs escalate.<\/p>\n Accurate Risk Scores Protect the Benchmark All Year<\/strong><\/p>\n Risk adjustment is not a mere compliance exercise, but it helps to set your savings goal at a reasonable level. Continuous capture and validation of HCC codes using encounter, lab, and pharmacy data helps keep risk scores current throughout the year.<\/p>\n Unified Platforms Close the Loop Between Alert and Action<\/strong><\/p>\n A common infrastructure breakdown affecting ACO performance in 2026 looks like this:<\/p>\n Analytics flags a high-risk patient → care manager sees it three days later → provider isn’t notified for another week → patient is admitted before anyone intervenes.<\/p>\n Unified infrastructure eliminates those gaps. When analytics, care management, and provider-facing tools share the same data layer, the loop closes fast enough to actually matter.<\/p>\n What High-Performing ACOs Do Differently<\/strong><\/p>\n Addressing ACO performance barriers requires improving the infrastructure that supports care management efforts. The ACOs consistently landing in shared savings have made specific decisions:<\/p>\n They’ve consolidated from 10+ tools to fewer, deeply integrated systems<\/p>\n They use AI-driven spend forecasting benchmarked against CMS methodology<\/p>\n They run continuous risk stratification as clinical data comes in<\/p>\n They push care gap alerts directly into provider workflows<\/p>\n Final<\/strong> Thoughts<\/strong><\/p>\n Long-term ACO performance is heavily influenced by infrastructure decisions made well before reconciliation occurs. The right platform can help ACOs address these eight barriers more effectively. ACOs that invest in unified, real-time, AI-driven systems stop reacting to data and start acting on it while there’s still time.<\/p>\n Persivia’s Digital Health Platform<\/a> is designed to help ACOs manage these infrastructure challenges. From real-time data aggregation and continuous HCC recapture to AI-powered forecasting and unified care management workflows, it gives ACOs the infrastructure to identify and address these gaps before they significantly affect financial performance.<\/p>\n Media Contact<\/span> They are insufficient, as the systems these clinicians have been using have not been designed to manage the requirements of value-based care. The data pipelines, platforms, and workflows between clinical decisions and financial outcomes play a direct role in shaping … Continue reading
Company Name:<\/strong> Persivia<\/a>
Email:<\/strong> Send Email<\/a>
Address:<\/strong>4 Mount Royal Avenue, 4th Floor
City:<\/strong> Marlborough
State:<\/strong> MA 01752
Country:<\/strong> United States
Website:<\/strong> http:\/\/persivia.com<\/a><\/p>\n<\/p>\n","protected":false},"excerpt":{"rendered":"