Description

A focused course, tailored for you

Building Modern ACO Operations and Healthcare Data Analytics (MSSP + REACH + Shared Savings + Quality + Risk Adjustment + AI in Care + Compliance)

Build the modern ACO operations and healthcare data analytics capability in 10 weeks. MSSP + REACH + shared savings + quality + risk adjustment + AI in care + compliance.

ACO operations leaders face MSSP and REACH performance pressure, shared-savings calculation complexity, quality-measure burden, risk-adjustment integrity, AI-in-care adoption, and CMS Innovation Center transition. Leaders who build the modern capability take the senior population-health work. Here is the 10-week build.

$199 one-time

Tailored to your situation. Access within 24 hours. 30-day money-back.

Includes a hand-built implementation playbook delivered alongside course access, generated for your specific situation.

Why this course

Accountable Care Organisation operations leaders at health systems, physician-led ACOs, payer-provider hybrid ACOs, and population-health management firms (Genesis HealthCare System, Geisinger, Atrius, Aledade, Privia Health, Agilon, agilon health, Astrana Health, Iora Health legacy, Oak Street Health legacy, ChenMed, P3 Health Partners, ApolloMD, Caravan Health, Bright Health Group legacy, Cano Health legacy, Humana CenterWell, Optum, CareMore, Devoted Health, Clover Health, Alignment Healthcare, Bright HealthCare legacy, Centene, Molina, Bright HealthCare legacy, Mercy Care, Banner Network Colorado, Cottage Health, ProHealth, Atlantic Medical Imaging, North Shore Physicians Group, Atrius Health, Steward Health Care, Mass General Brigham) face the shift in 2024-2026.

MSSP (Medicare Shared Savings Program) performance pressure under stricter benchmarks and higher minimum savings rates, REACH (ACO Realizing Equity, Access and Community Health) Model continuation through 2026 with potential successor model, shared-savings calculation complexity (benchmark + spend + risk-adjustment + quality + assignment methodology), quality-measure burden (Web Interface 10 measures vs CMS eCQM measures), risk-adjustment integrity under intensified CMS audit programmes (RADV, OIG, DOJ FCA), AI-in-care adoption (care-coordination, clinical-decision-support, prior-authorisation-automation, patient-engagement, predictive-risk-stratification), CMS Innovation Center transition under shifting Model portfolio, and compliance complexity (HIPAA Security Rule + Privacy Rule, 42 CFR Part 2 if SUD, FCA exposure on risk-adjustment) all need to land at the ACO operations layer.

Leaders who build the modern capability take the senior population-health work. Leaders who stay on classic claims-and-EMR-only analytics patterns watch the senior work shift to peers.

This course teaches the 10-week build of modern ACO operations and healthcare data analytics: MSSP + REACH framework, shared-savings calculation framework, quality-measure framework, risk-adjustment framework, AI-in-care framework, CMS Innovation transition framework, and the executive engagement model. Twelve modules with deliverables. Plus a hand-built implementation playbook for your specific ACO.

What you walk away with

A documented MSSP + REACH framework.
A shared-savings calculation framework.
A quality-measure framework.
A risk-adjustment framework.
An AI-in-care framework.
A CMS Innovation transition framework.
An executive engagement model.
A 10-week build plan.

The 12 modules

Module 1. ACO operations landscape 2026

Detailed walkthrough of the ACO operations landscape in 2026: MSSP performance trends, REACH Model continuation status through 2026, CMS Innovation Center Model portfolio (PPRO PFP, ENHANCED Track, etc), competitor ACO positioning, AI-in-care vendor landscape (Epic AI + Cosmos, Oracle Health AI, Innovaccer, Health Catalyst, Arcadia, Persivia, Algorex Health, Truveta, Datavant, Particle Health, Bamboo Health, in-house), regulatory landscape (HIPAA Security and Privacy, 42 CFR Part 2 if SUD, OIG audit programmes, DOJ FCA exposure on risk-adjustment, CMS RADV), and the strategic-level decisions facing ACO operations leaders.

Module 2. MSSP framework

Build the MSSP framework: MSSP Track selection (BASIC vs ENHANCED), beneficiary-assignment methodology, benchmark methodology, savings-and-loss methodology, minimum savings rate framework, minimum loss rate framework, quality-performance category framework, repayment-mechanism framework where applicable, ACO governance framework, and the integration with broader programme management.

Module 3. REACH Model framework

Build the REACH Model framework: REACH continuation status through 2026, REACH Direct Contracting Entities, REACH High Needs population framework, REACH Standard population framework, REACH Global capitation arrangement, REACH Professional capitation arrangement, REACH alignment-of-incentives framework, REACH equity-investment framework, and the integration with broader value-based-care strategy.

Module 4. Shared-savings calculation framework

Build the shared-savings calculation framework: benchmark calculation methodology, spend calculation methodology, risk-adjustment methodology, quality-adjustment methodology, assignment-methodology, savings-distribution-to-participating-providers framework, advance-payment methodology, and the integration with broader CFO management.

Module 5. Quality-measure framework

Build the quality-measure framework: APM (Alternative Payment Model) Performance Pathway, eCQM measure framework (Hypertension control, Diabetes control, Depression screening and follow-up, Colorectal cancer screening, Influenza immunisation, Pneumococcal vaccination, Statin therapy for cardiovascular disease prevention, Tobacco screening and cessation intervention, Falls screening, Patient-reported outcomes), Web Interface 10 measures framework where applicable, CAHPS for ACOs framework, measure-improvement plan framework, and the integration with broader quality strategy.

Module 6. Risk-adjustment framework

Build the risk-adjustment framework: HCC (Hierarchical Condition Category) coding framework with V28 model transition, MEAT (Monitoring, Evaluation, Assessment, Treatment) documentation framework, suspect-list framework, AI-augmented coding-review framework, OIG/RADV-defensibility framework, retrospective vs prospective review framework, provider-engagement framework, and the integration with broader compliance. The framework that prevents the FCA exposure event.

Module 7. AI-in-care framework

Build the AI-in-care framework: care-coordination AI framework (gaps-in-care identification, post-discharge follow-up, transitions-of-care optimisation), clinical-decision-support AI framework (preventive-care reminders, evidence-based-guideline integration), prior-authorisation-automation AI framework, patient-engagement AI framework (outreach optimisation, language-localisation), predictive-risk-stratification AI framework, ambient-listening clinical-documentation framework, and the integration with broader AI strategy.

Module 8. CMS Innovation transition framework

Build the CMS Innovation transition framework: Innovation Center Model portfolio analysis, Model-to-Model transition framework, AHEAD State Model framework where applicable, PCF (Primary Care First) framework where applicable, MCP (Making Care Primary) framework where applicable, KCC (Kidney Care Choices) framework where applicable, CKCC (Comprehensive Kidney Care Contracting) framework where applicable, and the integration with broader strategy.

Module 9. Healthcare data infrastructure

Build the healthcare data infrastructure: EHR-integration framework (Epic, Oracle Cerner, Meditech, Athenahealth, eClinicalWorks, Allscripts, NextGen, in-house), claims-data infrastructure, ADT (Admission Discharge Transfer) feed integration framework, SDOH (Social Determinants of Health) data framework, HIE (Health Information Exchange) integration framework, payer-data integration framework, data-warehouse selection (Health Catalyst, Innovaccer, Arcadia, Snowflake Healthcare, Databricks Healthcare, Google Cloud Healthcare, Azure Health Data Services, AWS HealthLake, in-house), and the integration architecture.

Module 10. Compliance framework

Build the compliance framework: HIPAA Security Rule compliance, HIPAA Privacy Rule compliance, 42 CFR Part 2 if SUD, OIG-audit-defensibility framework, DOJ-FCA-exposure framework, CMS RADV audit framework, state-medical-records-law application, breach-notification framework, and the integration with broader compliance.

Module 11. Executive and board engagement

Build the executive and board engagement: CMO partnership, CFO partnership, CIO partnership, COO partnership, CEO partnership, board-of-directors engagement framework, ACO Participation Committee engagement, payer engagement framework, and the integration with broader executive cadence.

Module 12. Your 10-week build plan

Week-by-week plan with weekly deliverables. Weeks 1-2: ACO operations landscape + MSSP framework. Weeks 3-4: REACH Model framework + shared-savings calculation framework. Weeks 5-6: quality-measure framework + risk-adjustment framework. Weeks 7-8: AI-in-care framework + CMS Innovation transition framework. Weeks 9-10: healthcare data infrastructure + compliance framework + executive engagement. Deliverable: modern ACO operations and healthcare data analytics capability.

How this addresses your situation

Specific modules that map to what you said you are dealing with.

Module 1 covers the landscape.

Module 2 produces MSSP framework.

Module 3 covers REACH Model framework.

Module 4 covers shared-savings calculation.

Module 5 covers quality measures.

Module 6 covers risk adjustment.

Module 7 covers AI in care.

Module 8 covers CMS Innovation transition.

Module 9 covers healthcare data infrastructure.

Module 10 covers compliance.

Module 11 covers executive engagement.

Module 12 covers the 10-week build plan.

What you get with this course

The 12-module course delivered as text plus downloadable templates.
Templates and worked examples for MSSP framework, REACH Model framework, shared-savings calculation framework, quality-measure framework, risk-adjustment framework, AI-in-care framework, CMS Innovation transition framework, healthcare data infrastructure, compliance framework, executive and board engagement.
A hand-built implementation playbook generated for your specific ACO.
Three worked examples of modern ACO operations and healthcare data analytics capabilities at peer ACOs.
Scripted talking points for the CEO and ACO Participation Committee engagement.

What you will have in hand by Day 1, Week 1, Month 1

Day 1: MSSP framework scaffold drafted.

Week 4: REACH + shared-savings calculation designed.

Week 8: Quality + risk adjustment + AI-in-care + CMS Innovation transition operational.

Week 10: Capability in operation.

Before and after

Before

Your ACO operations practice handles classic claims-and-EMR-only analytics. MSSP performance under stricter benchmarks strains the model. Risk-adjustment integrity under intensified CMS audit programmes worries leadership. AI-in-care adoption is reactive. Senior population-health work goes to peers shipping the modern capability.

After

A modern ACO operations and healthcare data analytics capability is in operation. MSSP framework, REACH Model framework, shared-savings calculation framework, quality-measure framework, risk-adjustment framework, AI-in-care framework, CMS Innovation transition framework, healthcare data infrastructure, compliance framework, executive and board engagement are all designed.

What happens if you do not address this

Leaders without the modern capability miss senior population-health work. MSSP benchmarks tighten, risk-adjustment integrity under CMS RADV + OIG audit + DOJ FCA scrutiny, and AI-in-care adoption pressure mounts.

Who it is for

For ACO operations leaders, Chief Population Health Officers, Vice Presidents for Value-Based Care, Senior Directors of Population Health, ACO programme managers, and senior healthcare data analytics leaders.

Who this is NOT for. Pure fee-for-service operations leaders without value-based-care scope. Operations leaders at firms with no ACO business. Pure claims-processing roles without analytics scope.

How it arrives

Text-based course via LMS, plus downloadable templates and worked examples and the hand-built implementation playbook.

Time investment. Roughly 18 hours of reading and 80 to 160 hours of operations-leader effort across the 10-week build.

Why $199 is the right number

External ACO consultants (specialist firms like Caravan Health, Lumeris, Lightbeam Health, Cerner Health Strategies, Optum Population Health Solutions, Premier Inc, Vizient consulting, Sg2 consulting, McKinsey Healthcare, BCG Healthcare, Bain Healthcare, Oliver Wyman Healthcare, Huron Consulting Healthcare) charge $300K-$1.5M for ACO modernisation programmes. $199 buys the focused playbook plus the implementation document for your specific ACO.

FAQ

Will this replace hiring an ACO modernisation consultant?

Partially. It teaches the modern capability. You may still want specialist input for advanced REACH operational design.

What if my ACO is primarily physician-led (not health-system-led)?

Modules 2, 4, and 11 cover physician-led patterns.

Does this cover Medicare Advantage operations specifically?

Modules 6 and 7 cover MA-anchored patterns.

What about Medicaid-managed-care operations?

Module 8 covers Medicaid-managed-care overlap.

What is in the implementation playbook for me specifically?

MSSP framework tailored to your specific ACO; risk-adjustment framework matched to your population; a 10-week build plan.

30-day money-back guarantee. If after a week of working through the materials this is not what you needed, reply to the receipt email and a full refund is processed. No questions, no forms.

Within 24 hours your account in the learning environment is provisioned and the tailored implementation playbook is delivered alongside it.