1upHealth for ACOs

Access claims and clinical data more frequently

With a FHIR API you can:

  • Receive CMS Medicare claims weekly or Medicaid data daily.
  • Receive population level claims and clinical feeds at any frequency enabled by a data sharing agreement between payers and providers.

Why ACOs Need Better Data

The primary mode of data sharing between ACOs and healthcare organizations are EHRs (electronic health records). They are a vital part of the data collection and analytics that drive the value-based reimbursement model utilized by ACOs.

In order to be successful, ACOs need to collaborate closely with their member organizations to develop the technical infrastructure required to share data appropriately across care sites – with less lag time and more frequent access to clinical data.

Without timely, secure access to EHR data, ACOs have a harder time determining and modeling predictions for risk, quality performance, and potential savings.

How 1upHealth Can Help

By providing access to the most near real-time data available in the market. FHIR is the industry common standard for exchanging healthcare data.

With healthcare’s most complete FHIR Data platform you can:

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Receive Medicare claims from CMS on a weekly basis.

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Receive claims from commercial payers & Medicaid on a daily basis.

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Consolidate clinical data across the provider network regardless of EMR.

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Push this more timely data into your current population health & analytics tools for more timely insights.

Additionally, with the upcoming redesigned ACO REACH model, CMS requirements will include the following:

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Requirement for all REACH ACOs to develop a Health Equity Plan that must include identification of health disparities and specific actions intended to mitigate the health disparities identified.

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Introduction of a health equity benchmark adjustment to better support care delivery and coordination for patients in underserved communities.

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Requirement for all ACOs to collect beneficiary-reported demographic and social needs data.

Access to claims data every 7 days via the Beneficiary Claims Data API (BCDA), rather than the current 30 day requirement, will be needed for success.

To learn more about how 1upHealth is here to help ACOs: