Meet Quality Measures Without Dedicated Analytics Staff
Small ACOs and independent practices in VBC contracts struggle with HEDIS gaps, MIPS complexity, and audit defense. OrbDoc captures quality measures automatically during documentation. Leave work on time while meeting measures.
Improved
HEDIS diabetes, hypertension, depression screening completion
60 seconds
Audit response time vs 15-30 hours
$500K-$2M
MSSP shared savings opportunity annually
Leave work on time
Document quality without quality burden
Why Small Practices Struggle with Value-Based Documentation
You're doing the clinical work. HEDIS measures, MIPS activities, quality outcomes. But without dedicated coding staff, it's not getting documented in a way that drives bonuses and shared savings. Quality measures become evening and weekend burden, not revenue opportunity.
HEDIS Gaps
Missed screenings and incomplete diabetes care documentation cost quality bonuses. HEDIS measures left incomplete without systematic prompts.
MIPS Complexity
Quality measures, improvement activities, promoting interoperability. Small practices lack coding staff to optimize. MIPS points lost annually.
ACO Attribution
Outcomes undocumented means lost shared savings opportunities. Documentation quality directly impacts MSSP performance. Revenue left on table annually.
Resource Constraints
No dedicated quality or coding staff like large systems have. Practice managers wear too many hats already. Quality measures become evening and weekend burden.
Built for Small ACOs and Independent Practices That Enterprise Solutions Overlook
Small ACOs (10-50 providers), independent practices in Medicare Advantage contracts, and FQHCs with VBC contracts face quality measure requirements without analytics teams. OrbDoc captures HEDIS, MIPS, and risk adjustment automatically during documentation.
Systematic Value-Based Care Capture
HEDIS Auto-Capture
Diabetes care (A1C, eye exams, nephropathy), preventive screening, chronic disease measures captured automatically during documentation.
MIPS Documentation
Quality measures, PI activities, improvement activities captured in real-time. No end-of-year scramble to prove what you did.
ACO Outcomes
Chronic disease outcomes, care coordination, transition documentation. Everything MSSP looks for to determine shared savings.
Quality Measure Prompts
Real-time alerts for missing HEDIS/MIPS opportunities. Close gaps during the visit, not months later.
Medicare Advantage
Star ratings documentation (HOS surveys, care plans). Capture what drives MA quality bonuses and contract renewals.
Gap Closure
Identify and close quality measure gaps systematically. Know which patients need which screenings before they walk in.
Value-Based Care Programs Supported
MSSP/ACO Programs
Shared savings documentation, chronic disease outcomes tracking, care coordination evidence for MSSP auditors
Medicare Advantage Contracts
Star ratings documentation, HCC coding accuracy, RAF score optimization, HOS survey capture
Commercial VBC Contracts
Commercial payer quality measures, outcomes documentation, utilization tracking for shared savings
HEDIS Measures
Diabetes care (A1C, eye exams, nephropathy), preventive screening, chronic disease management, depression screening
MIPS/MACRA
Quality measures, improvement activities, promoting interoperability documentation throughout the year
Health Equity Measures
SDOH screening, behavioral health integration (BHI), PHQ-9 depression screening, disparity reduction tracking
How It Works: Real Scenarios
Diabetes HEDIS Measures
Patient with diabetes comes in for routine follow-up
Traditional Approach
Provider documents visit, HEDIS gaps discovered months later during chart review, missed quality bonus opportunity
OrbDoc Approach
OrbDoc auto-prompts: A1C due, eye exam overdue, nephropathy screening needed. Provider orders during visit. HEDIS measures complete.
HEDIS diabetes measures: 43% → 78% completion rate
MIPS Quality Documentation
End of year, MIPS reporting deadline approaching
Traditional Approach
Scramble through charts trying to prove quality measures were met, incomplete documentation costs bonus payment
OrbDoc Approach
Quality measures documented automatically throughout year. Click button for MIPS report. High score, maximum bonus.
MIPS score improvement: 15-25 points average
ACO Shared Savings
CHF patient outcomes need documentation for MSSP
Traditional Approach
Good outcomes but poorly documented. ACO can't prove cost reductions. Shared savings not achieved.
OrbDoc Approach
Care transitions documented, outcomes captured, medication adherence tracked. MSSP auditors have evidence needed.
$85K-$125K additional shared savings (100-patient panel)
Success Patterns from Value-Based Care Programs
Small ACOs (10-50 providers)
Small ACOs participating in MSSP without dedicated analytics teams report systematic quality measure improvement.
- 40-60% improvement in HEDIS diabetes, hypertension, depression screening completion
- $500K-$1M additional MSSP shared savings through documentation improvement
- 60-second audit response vs 15-30 hours of chart review stress
Independent Practices in MA Contracts
Independent practices with 5-15 providers in Medicare Advantage contracts report improved risk adjustment and star ratings.
- 10-15% RAF score improvement from comprehensive HCC capture
- $50K-$150K quality bonus pool eligibility through star rating improvement
- Leave work on time while meeting quality measure requirements
FQHCs with VBC Contracts
Federally Qualified Health Centers in value-based contracts report systematic quality measure capture without adding staff.
- HEDIS measure automation for diabetes, hypertension, depression screening
- Health equity measure capture (SDOH, PHQ-9, BHI) built into workflow
- 95% reduction in audit response time with evidence-linking technology
Fee-for-Service vs Value-Based Documentation
Most providers were trained in fee-for-service documentation. Value-based care requires fundamentally different capture patterns.
Volume-Based Documentation
Leaves money on table in value-based contracts
Comprehensive Risk & Quality Documentation
Maximizes shared savings, quality bonuses, and risk-adjusted revenue
Common VBC Documentation Gaps
HEDIS Gaps
Missed screenings and incomplete diabetes care documentation cost quality bonuses. HEDIS measures left incomplete without systematic prompts.
MIPS Complexity
Quality measures, improvement activities, promoting interoperability. Small practices lack coding staff to optimize. MIPS points lost annually.
ACO Attribution
Outcomes undocumented means lost shared savings opportunities. Documentation quality directly impacts MSSP performance. Revenue left on table annually.
Resource Constraints
No dedicated quality or coding staff like large systems have. Practice managers wear too many hats already. Quality measures become evening and weekend burden.
MSSP Shared Savings Opportunity by ACO Size
Calculate your potential MSSP shared savings based on attributed lives. Documentation quality directly impacts your ability to reduce total cost of care and qualify for shared savings payments.
| ACO Size | Attributed Lives | Annual Spend | 15% Savings Opportunity | Shared Savings (50%) |
|---|---|---|---|---|
| Small ACO | 5,000-10,000 | $40M-$100M | 15% reduction = $6M-$15M savings | $3M-$7.5M |
| Medium ACO | 10,000-25,000 | $80M-$250M | 15% reduction = $12M-$37.5M savings | $6M-$18.75M |
| Large ACO | 25,000-50,000 | $200M-$500M | 15% reduction = $30M-$75M savings | $15M-$37.5M |
Technology Requirements for VBC Success
HEDIS Auto-Capture
Diabetes care (A1C, eye exams, nephropathy), preventive screening, chronic disease measures captured automatically during documentation.
MIPS Documentation
Quality measures, PI activities, improvement activities captured in real-time. No end-of-year scramble to prove what you did.
ACO Outcomes
Chronic disease outcomes, care coordination, transition documentation. Everything MSSP looks for to determine shared savings.
Quality Measure Prompts
Real-time alerts for missing HEDIS/MIPS opportunities. Close gaps during the visit, not months later.
Medicare Advantage
Star ratings documentation (HOS surveys, care plans). Capture what drives MA quality bonuses and contract renewals.
Gap Closure
Identify and close quality measure gaps systematically. Know which patients need which screenings before they walk in.
Revenue Opportunity for Value-Based Care Programs
Value-based care programs create multiple revenue opportunities. OrbDoc's systematic quality measure capture, HCC coding accuracy, and audit defense capabilities unlock HEDIS bonus payments, risk adjustment revenue, avoided penalties, and quality bonus eligibility.
Risk-Adjusted Payments (HCC)
10-15% RAF score improvement from comprehensive chronic disease documentation
Example: 15,000 lives × $800 PMPM × 15% RAF improvement = $1.44M additional revenue
Quality Measure Bonuses (Star Ratings)
HEDIS star rating improvement unlocks quality bonus pools
Example: 3.5→4.0 star improvement = $150K quality bonus for medium ACO
MSSP Shared Savings
15-20% total cost of care reduction through better documentation and care coordination
Example: 15,000 lives × $9,000 baseline × 16% reduction × 50% share = $10.8M savings
Audit Defense & Recoupment Prevention
Evidence-linking prevents HCC code recoupment and quality measure audit failures
Example: 7-year audio retention provides 60-second audit response with claim-level evidence
Primary care groups using auto-prompts report HEDIS diabetes measures improving from 43% to 78% completion. Quality bonuses and shared savings increase. Clinicians leave work on time instead of spending evenings on quality measure documentation.
ACO Medical Director
15-provider primary care group
Related Solutions
Medicare Billing
$25K-$148K annual opportunity: AWV, TCM, CCM, RPM optimization
Audit Defense
60-second audit response with evidence-linking technology
Revenue Intelligence
HEDIS, MIPS, HCC coding opportunities detected automatically
Primary Care
VBC contracts and quality measures for primary care practices
Document Quality Without Quality Burden
Join small ACOs and independent practices already improving HEDIS measures, MSSP shared savings, and risk-adjusted revenue while leaving work on time consistently.
40-60% HEDIS improvement + $500K-$2M MSSP opportunity + 95% faster audit response
Specialized support for ACOs, MSSP participants, and value-based care organizations