Why Quality Performance is a Competitive Advantage for ACOs

ACO quality performance is now a direct driver of shared savings, reimbursement, and payer relationships.

According to CMS, 476 Medicare Shared Savings Program (MSSP)ACOs participated in the program in 2024, providing care to nearly 10.3 million Medicare beneficiaries. Those organizations went on to generate a record $4.1 billion in total earned shared savings. These results underscore how closely quality and financial performance are linked in value-based care.

Yet many ACOs still rely on fragmented data and delayed reporting, making it difficult to act before opportunities are lost. Population health analytics gives organizations the visibility to identify care gaps sooner, align providers around performance, and improve quality outcomes at scale.

_{For executives, the takeaway is simple: quality performance must be managed continuously, not reported on after the fact.}

Why Quality Performance Remains So Difficult

Most ACOs do not struggle because they lack data. They struggle because their data lives in too many places.

Clinical data resides in multiple EHR systems, claims data arrives after the point of care, and quality teams often rely on spreadsheets, manual abstraction, and disconnected reporting tools to understand performance.

Just as important, ACOs need to trust the data before they can act on it. Validation should happen early and often, because broken data feeds, reporting gaps, and workflow inconsistencies can easily go unnoticed until they affect performance.

Now in 2026, with 511 MSSP ACOs covering 12.6 million beneficiaries, that challenge is even greater under the Alternative Payment Model (APM) Performance Pathway (APP) Plus quality reporting framework, where timely file review and validation are essential. CMS files can extend beyond the attributed population, so teams need a process to quickly review, reconcile, and act on data rather than letting it sit until the next reporting cycle.

Keeping provider Tax Identification Numbers (TINs) aligned and up to date is also important, particularly since APP, eCQM, and related reporting workflows depend on accurate organizational structure and attribution.

A native platform that intrinsically integrates population health analytics and quality measures is especially valuable here because it reduces the friction of stitching together separate reporting tools and provides ACOs with a single operational view of performance.  

_{Successful quality performance programs depend on more than reporting. They require trusted data, timely validation, aligned TIN structures, and the ability to reconcile CMS and payer-reported results before performance opportunities are lost.}

How Does Native Analytics Improve ACO Quality Performance?

Population health analytics gives teams year-round visibility into performance across the attributed population. But visibility alone is not enough; ACOs also need to review, validate, and act on incoming CMS files quickly, especially when those files extend beyond the attributed population and require timely reconciliation.

That makes quality measures reporting an ongoing operational process rather than a year-end exercise. 

A population health analytics platform helps organizations:

• Integrate clinical and claims data into a single source of truth
• Monitor measured performance throughout the year
• Identify care gaps at the patient level
• Prioritize outreach efforts
• Measure provider and practice-level performance
• Track improvement opportunities before reporting deadlines

This is particularly important for ACOs managing HEDIS-aligned measures and HCC risk adjustment workflows simultaneously. When those data streams are unified in a single platform, quality teams gain the cross-measure visibility needed to prioritize the interventions most likely to move the needle.

_{With population health analytics, quality improvement now moves from a retrospective reporting exercise into an ongoing operational process.}

How Can ACOs Close Care Gaps and Improve Quality Scores?

Preventive care gaps remain one of the largest opportunities for quality improvement and shared savings performance. CMS reported that, in PY 2024, ACOs improved on core measures tied to diabetes and blood pressure control, cancer screening, statin therapy, depression screening and follow-up, reinforcing the importance of closing care gaps throughout the year.

Population health analytics helps ACOs move beyond broad population reporting to patient-level action.

Instead of asking, “How are we performing on breast cancer screening?” organizations can ask:

• Which patients remain unscreened?
• Which providers have the largest number of open gaps?
• Which care gaps are most likely to impact quality performance?
• Which patients should outreach teams prioritize first?

_{Population health analytics transforms quality improvement from a retrospective exercise into an ongoing operational process.}

How Provider Scorecards and Workflow Integration Drive Quality Improvement

Technology alone does not improve quality performance.

Provider engagement is essential because clinicians need visibility into their own performance before they can change behavior. Wthout clear feedback, it is difficult for providers to understand where care gaps exist or how their actions affect quality outcomes.

Population health analytics creates that visibility through provider scorecards, performance benchmarking, and actionable insights.

When providers can see gaps within their patient panels, quality performance becomes more relevant and actionable.

Embedding care gap worklists and performance data into existing EHR workflows also helps align organizational goals with day-to-day clinical practice.

_{When quality data is embedded in clinical workflows, insight turns into action.}

How Quality Scores Directly Impact ACO Shared Savings and Revenue

Quality performance affects much more than regulatory reporting.

Strong quality scores influence shared savings opportunities, payer relationships, and reimbursement performance.

In MSSP, quality measure performance helps determine whether an ACO can share in savings and the extent to which it benefits financially from those savings. CMS’s current MSSP quality framework continues to tie quality performance to savings eligibility and financial outcomes, so quality remains a business metric even as the exact mechanics have evolved over time.

For ACOs participating in Medicare Advantage or commercial value-based contracts, quality performance also influences Star Ratings and payer-specific incentive payments.

For a high-performing ACO generating $10 million in gross savings, even a small difference in quality performance can represent meaningful revenue. As value-based care models continue to mature, organizations that consistently perform well on quality measures will be better positioned to maximize revenue opportunities while improving patient outcomes.

ACO teams should validate payer-reported quality data against their own records and, when needed, send supplemental clinical files to reconcile discrepancies and improve reporting accuracy.

Case Study: Several ACOs have discovered that payer-reported quality performance does not always fully reflect the care delivered. Validating reported results, reconciling discrepancies, and submitting supplemental clinical data when appropriate can significantly improve measure accuracy. This was a key lesson demonstrated in Koan Health's work with Nebraska Healthcare Network (NHN), where clinical data validation helped improve reporting accuracy and quality performance.

What Does a Sustainable ACO Quality Performance Program Look Like?

The most successful ACOs are moving beyond periodic reporting and building year-round performance management programs to keep pace with APP Plus, quarterly CMS files, and multi-source data validation.

A sustainable program also treats validation as an ongoing discipline. EMRs change, interfaces evolve, and data sources shift, so teams need periodic audits, spot checks, and clear ownership across quality, IT, providers, and analytics partners.

These organizations share several common characteristics:

• Unified clinical and claims data
• Real-time performance visibility
• Patient-level care gap identification
• Provider performance transparency
• Integrated care management workflows
• Continuous monitoring and intervention

Population health analytics serves as the foundation connecting these capabilities and supporting broader efforts to manage utilization, reduce unnecessary costs, and improve financial performance.

Organizations using population health analytics such as Koan Health can unify clinical, claims, and attribution data across multi-EHR environments, giving quality teams the visibility needed to move from reactive reporting to proactive performance management.

Turning Quality Performance Into Competitive Advantage

For ACOs, quality is a business metric, and improving performance requires continuous operational discipline.

As APP Plus reporting requirements expand and financial incentives become increasingly tied to quality outcomes, ACOs need more than compliance tools. They need actionable intelligence.

Population health analytics provides the visibility to identify care gaps, align providers, and support continuous performance improvement across MSSP, Medicare Advantage, and other value-based care programs.

The organizations that will lead in value-based care are not the ones that report quality best. They are the ones that manage quality performance continuously—and use data to turn quality from a compliance obligation into a competitive advantage.

Ready to Improve Quality Performance?

See how Koan Health helps ACOs identify care gaps, align providers, and improve outcomes through population health analytics. Explore now.

Related Reading

• How Population Health Analytics Improves Risk Stratification and HCC Performance

• ACO Cost Drivers: How to Reduce Utilization and Improve Margin