Case Study · Value-Based Care · MSSP ACO
Midwest Health System ACO Achieves $3.1M in Shared Savings in Year 2
From reactive to predictive: how a 12-hospital Midwestern ACO turned its population health analytics from a compliance tool into a revenue engine.
The situation before SolvEdge
This ACO entered MSSP Track 2 in year three of their value-based care journey. They had invested significantly in their Epic Healthy Planet implementation and had a team of 22 care managers. The data wasn't the problem. The problem was that their care managers were spending 60% of their time managing their work lists manually — sorting spreadsheets, making calls without context, and reacting to hospitalizations that had already happened. Their Year 1 MSSP result was a small shared savings amount that leadership knew significantly underperformed their potential. The quality scores were improving but the total cost of care wasn't moving fast enough.
The core gap: their risk stratification was producing the right patient lists, but there was no structured workflow connecting those lists to care manager actions within a timeframe that mattered. High-risk patients were identified. Outreach happened weeks later — if at all — because every care manager was managing their panel differently.
"We had the data. We didn't have the workflow. SolvEdge helped us stop treating our analytics platform as a report and start treating it as a command center."
— VP of Care Management, Midwest Health System (anonymized)
What SolvEdge did — in four phases
Weeks 1–4: Claims-to-action gap analysis
SolvEdge analyzed 18 months of claims data alongside care manager workflow logs. Identified that the average lag between a high-risk patient alert and a care manager outreach call was 23 days. Industry benchmark for effective programs: 72 hours.
Weeks 5–10: Care manager workflow redesign
Rebuilt the care manager work list architecture within their existing population health platform. Implemented a tiered intervention protocol — Level 1 (same-day), Level 2 (48-hour), Level 3 (weekly) — based on risk score and recent utilization signals. Eliminated manual list management entirely.
Months 3–5: Physician engagement program
Launched a quarterly surgeon and PCP performance report — cost, quality, and utilization vs. peer benchmark — delivered directly to physician inboxes with a 1-page summary and 2 recommended actions per physician.
Ongoing: PAC utilization analytics + MSSP financial modeling
Deployed SolvEdge's post-acute analytics to identify the ACO's 8 highest-cost SNF partners by readmission rate and LOS. Initiated renegotiation with the bottom 3. Built a monthly MSSP financial model showing projected shared savings vs. benchmark — updated as new claims data arrived.
What they learned that others can apply
The single change that drove the most Year 2 improvement wasn't a technology deployment — it was reducing the alert-to-action lag from 23 days to under 72 hours. Everything else built on that foundation. Organizations that are frustrated with their ACO performance and blame their analytics platform should first audit how fast they're actually acting on the data they already have.
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