The Pulse Platform — Built for MSSP ACOs

Healthcare Solutions with a Pulse.

Quality measure reporting across every CQM pathway, RAF coding accuracy grounded in clinical evidence, and claims analytics down to the physician level — the three numbers your ACO's shared savings depend on.

Talk to an Expert See What We Do
100%
Submission success
10%+
Of the MSSP market served
3
CQM pathways, run in parallel
14th
Year serving ACOs
pulse.acohealthsolutions.com
RAF Optimization Calculator — The Pulse Platform
Audit-ready by design
CMS-HCC V28 · within the 3% cap
Certified & Designated
HITRUST e1 Certified HITRUST e1 Certified ONC Certified Health IT — Drummond ONC Certified Health IT CMS Qualified Registry Clinical Data Registry HIPAA Compliant
What We Handle

Everything your ACO's savings depend on, in one place.

Every service runs on The Pulse Platform — the same HITRUST e1 certified engine, the same data, one team accountable for all of it.

01

Quality Measure Reporting

eCQM, MIPS CQM, and Medicare CQM calculated in parallel — we submit whichever scores highest.

02

ACO Performance Report

A deep financial and utilization profile — plus your top initiatives for next year, dollarized.

03

Risk Adjustment & HCC

RAF coding accuracy backed by clinical evidence — a more accurate benchmark, audit-ready.

04

Claims & Financial Analytics

Spend vs. benchmark at the ACO, practice, and physician level — see where the dollars go.

05

Promoting Interoperability

ACO-level PI reporting plus automatic PI_PHCDRR_5 bonus points through our CDR.

01 — Quality Measure Reporting

Three CQM pathways. We submit the one that scores highest.

Most registries calculate one quality pathway and hope for the best. We run all three — eCQM, MIPS CQM, and Medicare CQM — in parallel, then submit whichever combination delivers your ACO the highest score.

All three CQM pathways calculated simultaneously, per measure
Performance tracked against the National Average and PY Benchmark
Decile ranking with the exact gap to the next and max decile
Real-time score tracking throughout the performance year
pulse.acohealthsolutions.com / all-measures
All Measures Dashboard — measure performance, deciles, contributing practices, and gap opportunities
FIG. 01 — All Measures Dashboard: live performance, deciles, and gap opportunities by practice
Talk to us about reporting
Data We Accept
CCDA / CDA QRDA I & III HL7 FHIR HL7 v2 CSV / Flat File Claims (837/835) Direct EHR Integration API Access
02 — ACO Performance Report

Know your position. Fund next year's plan.

A deep financial and utilization profile of your ACO — your CMS benchmark position, what's driving every PMPY move, and drilldowns from SNF facilities to imaging site-of-service. It closes with the highest-leverage initiatives for the next performance year, each one dollarized.

Benchmark position and full shared-savings math — MSR, sharing rate, sequestration
PMPY decomposition — utilization vs. unit cost, category by category
Drilldowns: SNF, ED, imaging, dialysis, hospice, specialist and PCP scorecards
Dollarized initiative scenarios for the next performance year — with backing workbooks
Benchmark Position SAMPLE · EVERGREEN ACO · PY2025
−1.39%
under the estimated final benchmark
PMPY vs. benchmark −$188
Favorable variance $2.13M
Est. net shared savings ~$1.04M
Attributed members 11,312
Where the Spend Concentrates — PMPY by Category YoY
Facility Outpatient
$3,985 +7.4%
Inpatient
$3,601 +3.2%
Professional
$2,803 −6.1%
DME
$715 +41.4%
Other (incl. HH)
$392 −5.3%
The top three categories hold 90% of medical spend — a 2% move here outweighs a 30% cut in the smallest lines. Red bars and deltas flag the intervention targets.
Top Initiatives for the Next Performance Year — Dollarized Each backed by an editable savings workbook
T1
$4.58M/yr
HCC documentation capture
Max benchmark uplift within the CMS 3% RAF cap — the largest unworked lever.
T2
$4.2M
Hold the top 3 categories flat
Holding Facility OP, Inpatient, and Professional to prior-year PMPY roughly triples the savings margin.
T3
$3.22M
Imaging site-of-service
Gross pool from steering CT / MRI / PET to the lowest-cost appropriate tier.
T4
$6.93M
Preferred specialty network
Steerable specialist spend — curated by cost, quality, and PCP feedback loops.
FIG. 02 — Sample output from a demo ACO. Your report runs on your own claims data.
Request a sample report
03 — Risk Adjustment & HCC Coding

Turn accurate documentation into shared savings.

Your providers are already delivering the care — the documentation just doesn't always reflect it. Our RAF Coding Accuracy Program screens your full attributed population against clinical evidence — lab results, medication histories, specialist claims, prior-year diagnoses — and surfaces the coding gaps your practices are leaving on the table.

Not upcoding — just accurate coding. Every recommendation is audit-ready.
pulse.acohealthsolutions.com / raf-calculator
RAF Optimization Calculator — full-population risk adjustment modeling using CMS-HCC V28
FIG. 03 — RAF Optimization Calculator: full-population modeling on CMS-HCC V28
The Problem

HCC codes reset every year. Chronic conditions fall off the risk score if they aren't re-documented during the performance year — and many actively treated complications never make it onto a primary care claim. The result: your benchmark understates the true complexity of your population, leaving shared savings on the table.

How It Works — Three Tiers of Opportunity
T1

Complication Gap Closure

Diabetic patients coded without complications whose labs, specialist claims, or medications indicate nephropathy, retinopathy, neuropathy, or vascular disease. We flag the evidence — your providers confirm and document.

T2

Condition-Specific Screening

Population-wide identification of undocumented or underspecified conditions — CKD, heart failure, COPD, depression, morbid obesity, atrial fibrillation — every flag backed by clinical data already in the system.

T3

Annual HCC Recapture

Chronic conditions documented last year that haven't been re-coded in the current performance year — typically the largest single source of lost RAF, and the easiest to fix.

What Your Practices Receive

Patient-level gap reports before scheduled visits, each showing the specific clinical evidence behind the recommendation: lab values, active medications, specialist claims, prior-year coding history. Providers make the final clinical determination — we surface the data.

Built on CMS-HCC V28

Screening logic reflects the current V28 category structure — the expanded heart failure hierarchy, the CKD Stage 3/3B split, updated diabetes complication mapping. As CMS transitions from V24 to V28, your program stays current.

Measurable Results

A financial impact projection at the start of the year, modeled against the CMS 3% risk score growth cap. Quarterly tracking of actual vs. projected RAF movement, and year-end reconciliation of exactly how much savings came from documentation improvements.

Compliant by Design

Every recommendation is grounded in clinical evidence already present in the patient's record. We operate within the CMS risk score growth cap, on a HITRUST e1 certified platform that protects your data throughout.

Talk to Us About RAF Accuracy
pulse.acohealthsolutions.com / provider-scorecard
ACO Provider Scorecard — Physician, Practice, and ACO level analytics
FIG. 04 — Provider Scorecard: claims paid through 2025-12-26
04 — Claims & Financial Analytics

See exactly where the dollars are going.

Shared savings start with understanding your spend. Our Provider Scorecard breaks down claims data at the physician, practice, and ACO level — so you can see where the money goes and where the opportunities are.

Expenditures vs. benchmark PMPY at every level
Annual Wellness Visit and Transitional Care rates
ED utilization, inpatient admits, readmissions, and home health
Drill down from ACO → practice → physician
Talk to us about claims analytics
05 — Promoting Interoperability

Bonus points most ACOs leave on the table.

Your ACO reports Promoting Interoperability through us as a CMS Qualified Registry. And because you're participating in our Clinical Data Registry, you earn bonus points on measure PI_PHCDRR_5 automatically. Two designations, one platform.

ACO-level PI reporting through our CMS Qualified Registry
PI_PHCDRR_5 bonus points earned through CDR participation
Compliance tracking, documentation, and EHR integration
No additional reporting burden on your practices
Talk to us about PI reporting
PI Score — ACO Level PI_PHCDRR_5
Report PI through a CMS Qualified Registry Included
Clinical Data Registry participation Included
Extra burden on practices None
PI_PHCDRR_5 bonus points + Earned
Automatic with CDR participation — a competitive edge over ACOs reporting through non-qualifying registries.
Why ACO Health Solutions

Built for MSSP ACOs. Nothing else.

We're not a massive platform trying to be everything to everyone. We're a focused team that knows MSSP inside and out — and we move fast.

Clinician holding a heart with a pulse line — care your data should reflect

HITRUST e1 Certified Platform

Our data analytics platform has achieved HITRUST e1 (Essentials, 1-Year) Certification — demonstrating the highest standard of information security for the systems that handle your data.

Visit our Trust Center

Triple-Path Scoring

Most registries calculate one quality pathway. We run eCQM, MIPS CQM, and Medicare CQM — and submit whatever scores highest for your ACO.

PI Reporting + CDR Bonus

Report PI at the ACO level through our CMS Qualified Registry — and earn PI_PHCDRR_5 bonus points through Clinical Data Registry participation. Two designations, one platform.

Small Team, Fast Moves

No bureaucracy, no ticket queues. You work directly with the people who built the platform. When CMS changes the rules, we adapt — fast.

The Pulse Portal

One login for everything your ACO tracks.

Quality scores, provider scorecards, RAF gap reports, and PI tracking all live in one place — behind a single HITRUST e1 certified login. No spreadsheets flying around, no waiting on a monthly export.

Sign in to Pulse
pulse.acohealthsolutions.com
The Pulse Portal — secure login
FIG. 05 — The Pulse Portal: one secure login for your whole ACO

Meet the team — coming soon

Profiles of the people who build and support The Pulse Platform.

Meanwhile, talk to us directly
Get In Touch

Let's maximize your ACO's score.

Tell us about your ACO and we'll show you exactly how we can help. No pressure, no fluff.

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Or email [email protected] directly.