MSSP & LEAD ACO
Under the Shared Savings Program's APP Plus measure set, every MSSP ACO now reports four clinical quality measures, the CAHPS for MIPS survey, and an administrative readmission measure through eCQM, MIPS CQM, or Medicare CQM pathways — and the resulting quality score is a direct multiplier on shared savings earned. For LEAD ACOs, the requirements are broader still: REACH's claims-based measures and CAHPS carry forward, new eCQMs are phasing in, a Prevention and Quality Plan is required, and wherever capitated payment options apply, CMS still needs a complete encounter-data record in place of standard claims — the same record CMS uses for risk adjustment and reconciliation.
Measure to Margin modules
Both problems are solvable with the right analytics foundation, and that's what HCSTRATEGY built Measure to Margin to do. It's organized into six modules that can run standalone or as a full build:
- •Quality Measure Readiness & Submission Support — pathway selection, measure calculation validation, CAHPS analytics, and submission-cycle project management.
- •Care Gap & Performance Analytics — attributed-patient-level care gaps turned into prioritized outreach lists and practice-level scorecards.
- •Risk Adjustment & HCC Documentation Support — chart review prioritization, coding gap analysis, and documentation workflows that produce defensible risk scores.
- •Encounter Data Completeness & Claims Integration — completeness audits, reconciliation ahead of CMS processing cycles, and multi-payer integration for LEAD's Medicare-Medicaid alignment.
- •Financial Performance & Shared Savings Modeling — benchmark tracking, savings/loss simulation, and reconciliation/variance support tied directly to the number your board cares about.
- •Executive & Governance Reporting — automated, board-ready dashboards and PQP development support for LEAD ACOs.
Engagement approach
Engagements run across four phases — Assess, Build, Operationalize, and Monitor & Optimize — timed to your actual submission calendar rather than an abstract project plan.
- •Readiness Assessment — a fixed-scope diagnostic for ACOs unsure where they stand.
- •Embedded Advisory — a monthly retainer for ACOs with in-house data capability that need sustained CMS-program expertise.
- •Full Project build — carried through your first live submission and reconciliation cycle.
The goal is simple: make sure every quality point your ACO earns and every dollar of encounter data it submits actually reaches the bottom line.
Download MSSP & LEAD ACO Measure to Margin