See the Whole Picture: How ACOs Gain Strategic Insight with an Enterprise View

As an Accountable Care Organization (ACO) leader, you're juggling multiple dashboards, potentially tracking Commercial programs in one system or relying on payer portals, Medicare Advantage (MA) in another, and MSSP in yet another. You're making critical decisions about resource allocation, quality improvement initiatives, and care coordination—but are you seeing the full picture?

The reality is that 476 ACOs are now participating in the Medicare Shared Savings Program for Performance Year 2025, serving more than 11.2 million people with Traditional Medicare. However, beyond Medicare, many of these same ACOs also manage commercial and Medicare Advantage programs. Without a unified view across all these programs, you're essentially flying blind to enterprise-wide trends that could be impacting your organization.

The Hidden Cost of Fragmented Analytics

Over 60% of healthcare executives cite data silos as a major barrier to leveraging analytics effectively. When your population health data sits in separate silos—one for each program type—you're missing critical insights that only emerge when you look at the complete picture.

Consider this scenario: You notice DME fraud eating into your MSSP margins, but is it isolated to Medicare? Or is the same pattern affecting your Commercial and MA programs? Without an enterprise view, you might implement a solution that addresses only part of the problem, leaving money on the table across other program lines.

Siloed patient information poses a significant barrier to healthcare organizations striving to achieve value-based care goals and deliver high-quality care. When patient data is compartmentalized across different programs, you lose the ability to see enterprise-wide patterns, coordinate care effectively, and identify opportunities for system-level improvements.

What is Enterprise View—and Why Does It Matter?

An enterprise view is a fundamentally different approach to population health management that integrates all your program types—Commercial, Medicare Advantage, and MSSP—into one cohesive platform.

This matters because trends that affect your entire organization often don't show up when you're analyzing programs individually. Data analysts spend between 50 to 80 percent of their time on data preparation tasks, struggling to convert it into a manageable format. That's the majority of your team's time spent wrestling with data instead of acting on insights.

With an enterprise view, you can immediately see:

• How your organization is tracking across all program lines combined
• Which trends are affecting multiple programs versus being isolated to one
• Where your greatest opportunities for improvement lie across the entire enterprise

The Power of Strategic Data Analytics

One of the most valuable capabilities of an enterprise view is the ability to aggregate results across program types. You can see combined data-driven performance for all your Commercial programs, all your MA programs, and all your MSSP programs—then drill down to identify which specific programs are driving the results.

This is particularly important because different program types have fundamentally different cost benchmarks and performance expectations. Commercial members have different utilization patterns than Medicare Advantage members, who in turn differ from traditional Medicare beneficiaries. Trying to compare them directly is like comparing apples to oranges.

But when you aggregate by program type first, you create meaningful comparisons. Your providers can see how they're tracking across all their Commercial patients combined, or all their Medicare patients combined—without getting lost in the weeds of individual payer contracts.

Data Analytics Hierarchy: From 30,000 Feet to Ground Level

The true power of enterprise view lies in its hierarchical approach to data analysis. Think of it as a pyramid for improved decision-making:

Level 1: Enterprise View (The Data Driven Foundation)
At the top, you see the big picture—how is your entire organization performing across all programs? This is where you spot major trends, identify enterprise-wide issues, and set strategic priorities.

Level 2: Program Type Aggregation
Next, you drill down by program type. How are all your Commercial programs performing compared to all your MA programs versus MSSP? This reveals whether specific program types are driving your results—positive or negative.

Level 3: Individual Program Performance
Now you can isolate which specific programs within each type are excelling or underperforming. Is it your UHC Commercial contract that's dragging down Commercial results, or is it Aetna?

Level 4: PCP Group Results
At this level, you see how different provider groups are performing within each program.

Level 5: Individual PCP Performance
Drill further to see individual provider performance.

Level 6: Patient-Level Insights
Finally, you can examine specific patients who are driving results or who need targeted interventions.

This hierarchy is critical because it always starts with context. You understand the enterprise-wide picture before diving into specifics, ensuring that you're addressing root causes rather than just symptoms.

How Providers Actually Use This: Real-World Application

Let's look at how this plays out in practice. A primary care physician doesn't typically care whether a patient has UHC Commercial coverage versus Aetna Commercial. What matters to them is understanding how they're managing their overall patient population across program types to improve patient care and health outcomes.

That's why custom data-driven reporting by program type is so powerful. A PCP Group can create a scorecard that shows their performance across "all Commercial programs combined" and "all Medicare programs combined." They can immediately see if their IP Admits rate is dramatically different for Medicare patients versus Commercial patients, or if their Medical PMPM varies significantly by program type.

This approach eliminates unnecessary complexity while preserving the important distinctions. Providers get actionable insights without drowning in payer-specific details they don't need.

Centralized Data Management for Comprehensive Patient Care

Beyond aggregated reporting, enterprise view enables something even more powerful: a unified patient list that displays all patients and the metrics that matter, regardless of which program or program type they're in.

A 2024 Forrester study revealed that 52% of health system executives believe lack of integrated data is the biggest barrier to delivering effective care. When your data is centralized in one repository, providers can focus on care delivery rather than navigating multiple systems to piece together a patient's story.

This centralization supports the entire continuum of value-based care delivery. According to CMS, the Medicare Shared Savings Program saved Medicare $2.5 billion in 2024 through its work with ACOs—but imagine the additional savings possible when you can optimize across all program types simultaneously.

The goal is simple: one platform, one repository, multiple analytical perspectives. This allows you to run analysis at any level of your organization, from enterprise-wide strategic planning down to individual patient interventions.

How Datalyst Enables Enterprise View

At Koan Health, we built our population health analytics platform, Datalyst, on a fundamental principle: trusted data drives trusted actions. When you trust your data, you can trust the actionable insights, and you can be confident in the actions needed to achieve your performance results.

Datalyst's enterprise view capability provides:

Unified Cost and Utilization Tracking
See cost performance across all service lines and providers for each value-based care agreement, all in one place. Quickly pinpoint opportunity areas to drive improvement initiatives and address cost and utilization outliers against target benchmarks.

Comprehensive Network Leakage Analysis
Discover what's driving activity outside your network across all programs. Filter in and out-of-network spend by practice, region, service type, and provider—then identify opportunities for more effective and coordinated care.

Post-Acute Care Optimization
Evaluate PAC provider performance across all your programs using metrics like average cost of care per visit, length of stay, and readmission rates. Drill into cost and utilization for home health, hospice, rehab, and SNF with enterprise-wide visibility.

Provider Performance Monitoring with Context
Monitor provider progress against goals and ACO averages across all programs. Access PCP costs inclusive of risk adjustment and benchmark services between similar specialists—all with the enterprise context you need for meaningful comparisons.

Patient Outcome Improvement
Compare cohorts to measure the impact of clinical interventions across program types. Review patient profiles that integrate medical and pharmacy claims, labs, clinical events, and contract information—all in one comprehensive view.

Throughout Datalyst, data integrity, data quality, and data transparency are paramount. Healthcare data analytics is often limited due to data fragmentation and a lack of standardized digitalization—but Datalyst eliminates these barriers by creating a single source of truth that maintains quality and consistency across all your data.

The Transformation: From Fragmented to Unified

The healthcare industry is at a critical juncture. As of January 2025, 53.4% of people with Traditional Medicare are in an accountable care relationship with a provider, and value-based care continues to expand into Commercial and Medicare Advantage markets. The financial stakes are significant—organizations need comprehensive analytics to succeed.

You can't afford to have fragmented data guide your decision-making and program-specific analytics. The stakes are too high, and the opportunities too significant.

When you adopt an enterprise data management approach, you transform from:

• Reactive to proactive: Spot trends before they become problems
• Fragmented to unified: One platform, one truth, infinite perspectives
• Tactical to strategic: Make decisions based on enterprise-wide context
• Isolated to integrated: See how all your programs work together

The global AI in healthcare market size was $19.27 billion in 2023 and is expected to grow at a compound annual growth rate of 38.5% through 2030. But without integrated data, you can't leverage these advanced analytics capabilities. An enterprise view isn't just about better reporting—it's about positioning your organization for the future of healthcare analytics.

Take the Next Step

The question isn't whether you need an enterprise view—it's whether you can afford to operate without it. As value-based care models continue to evolve and expand, the ACOs that thrive will be those that can analyze performance holistically, identify opportunities across all program lines, and act decisively based on comprehensive insights.

Start by evaluating your current data analytics approach:

• Are you seeing trends across all your programs, or just within individual programs?
• Can your providers easily compare performance across program types?
• Do you have a single source of truth, or are you reconciling data from multiple systems?
• Can you seamlessly drill from enterprise-wide strategic insights to patient-level interventions?

If you answered "no" to any of these questions, it's time to explore what enterprise view can do for your organization.

Learn More

Koan Health's Datalyst platform provides the enterprise view and advanced analytics capabilities you need to succeed in value-based care. Our platform eliminates data disparities and improves clinical, financial, and patient outcomes with actionable insights from advanced analytics and workflows.

Ready to transform your population health analytics?
Schedule a demo to see how Datalyst can help you achieve your value-based care goals.

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