Healthcare Solutions with a Pulse
Your ACO's shared savings depend on accurate quality scores, accurate risk scores, and knowing where the money's going. We handle all three — quality measure reporting across every CQM pathway, RAF coding accuracy that captures what your providers are already doing, and claims analytics down to the physician level.
Quality Measure Reporting
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
- ✓Optimal submission path selected per measure
- ✓Performance vs. National Average and PY Benchmark
- ✓Decile ranking with gaps to next and max decile
- ✓Real-time score tracking throughout the performance year
Claims & Financial Analytics
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 exactly where the dollars are going and where the opportunities are.
- ✓Expenditures vs. benchmark PMPY at every level
- ✓Annual Wellness Visit and Transitional Care rates
- ✓ED utilization, inpatient admits, and readmission tracking
- ✓Home health costs and utilization analysis
- ✓Drill down from ACO → Practice → Physician
Promoting Interoperability
Your ACO reports Promoting Interoperability through us as a CMS Qualified Registry. And because you're participating in our Clinical Data Registry, your ACO earns bonus points on measure PI_PHCDRR_5 automatically. Two designations, one platform — points most ACOs are leaving on the table.
- ✓ACO-level PI reporting through our CMS Qualified Registry
- ✓PI_PHCDRR_5 bonus points earned through CDR participation
- ✓Compliance tracking and documentation
- ✓Integration with your existing EHR systems
RAF Coding Accuracy Program
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 identifies documentation gaps across your entire attributed population and gives your providers the clinical evidence they need to capture what's already true — resulting in a more accurate benchmark and stronger shared savings performance.
Using The Pulse Platform's analytics engine, we systematically screen your beneficiaries against clinical evidence — lab results, medication histories, specialist claims, and prior-year diagnoses — to surface coding gaps your practices are leaving on the table.
HCC codes reset every year. Chronic conditions your patients have had for years fall off the risk score if they aren't re-documented during the performance year. On top of that, many complications are actively being treated — by specialists, through medications, confirmed by lab results — but never make it onto a primary care claim. The result: your benchmark understates the true clinical complexity of your population, leaving shared savings on the table.
How It Works
The Pulse Platform screens your full attributed population across three tiers of opportunity:
Complication Gap Closure
Diabetic patients coded without complications who have lab results, specialist claims, or medications indicating nephropathy, retinopathy, neuropathy, or vascular disease. We flag the evidence. Your providers confirm and document.
Condition-Specific Screening
Population-wide identification of undocumented or underspecified conditions including chronic kidney disease, heart failure, COPD, depression, morbid obesity, and atrial fibrillation. Every flag is backed by clinical data already in the system.
Annual HCC Recapture
Chronic conditions documented last year that haven't been re-coded in the current performance year. This is typically the largest single source of lost RAF — and the easiest to fix.
What Your Practices Receive
Patient-level gap reports delivered before scheduled visits, each showing the specific clinical evidence supporting the recommendation: lab values, active medications, specialist claims, and prior-year coding history. Providers make the final clinical determination — we surface the data so nothing falls through the cracks.
Built on CMS-HCC V28
Our screening logic reflects the current CMS-HCC Model V28 category structure, including the expanded heart failure hierarchy, the CKD Stage 3/3B split, and updated diabetes complication mapping. As CMS transitions from V24 to V28, your coding accuracy program stays current.
Measurable Results
Every ACO receives a financial impact projection at the start of the performance year showing estimated benchmark improvement by category, modeled against the CMS 3% risk score growth cap. Progress is tracked quarterly with actual versus projected RAF movement, and year-end reconciliation quantifies exactly how much of your shared savings is attributable to documentation improvements.
Compliant by Design
Every recommendation is grounded in clinical evidence already present in the patient's medical record. We operate within the CMS risk score growth cap and our HITRUST e1 certified platform ensures your data is protected throughout the process.
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.
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 CenterTriple-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. Because your ACO participates in our Clinical Data Registry, you earn bonus points on PI_PHCDRR_5. 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.
Meet the Team
The people behind the platform — coming soon.
Under Construction
We're putting together team profiles so you can get to know the people who build and support The Pulse Platform. Check back soon.
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.