Electronic health records have become the backbone of successful Accountable Care Organizations, directly influencing their ability to achieve shared savings and meet quality benchmarks. More than 90% of ACOs operate with multiple EHR systems, with 77% using six or more different platforms, creating both opportunities and challenges for data-driven care coordination.
Key Takeaways
- EHRs enable ACOs to track quality measures and coordinate care across multiple providers and settings.
- Most ACOs use multiple EHR systems, requiring sophisticated data integration strategies for optimal performance.
- Electronic clinical quality measures (eCQMs) will eventually become mandatory for ACO reporting, especially with the rise of dQMs.
- Real-time data access through EHRs helps ACOs identify cost-saving opportunities and improve patient outcomes.
- Standardized data collection through EHRs supports accurate risk adjustment and benchmark calculations for shared savings.
The Foundation of ACO Performance
ACOs that provide higher quality, coordinated care and improve patient health outcomes while reducing Medicare spending may be eligible to share in a portion of those savings. This performance-based model requires robust data infrastructure, making EHRs essential for success.
The relationship between EHRs and ACOs in healthcare extends beyond simple documentation. These systems capture the clinical data points that determine whether an ACO meets quality thresholds and achieves the cost reductions necessary for shared savings eligibility.
When providers within an ACO can access comprehensive patient records across different care settings, they make more informed decisions. This leads to:
- Reduced unnecessary tests and procedures
- Prevention of costly readmissions
- Earlier identification of patients needing preventive care
- Better medication management across transitions of care
Data Integration: The Multi-EHR Challenge
Only 9% of ACOs use a single EHR system. This fragmentation creates significant obstacles for collecting, analyzing, and reporting the quality measures that determine shared savings eligibility.
Common Integration Strategies Include:
- Health Information Exchanges (HIEs) that connect disparate systems
- Third-party analytics platforms that aggregate data from multiple sources
- Custom API integrations between EHR vendors
- Data warehousing solutions that standardize information from various platforms
The complexity increases when ACOs need to report population-level metrics. Patient data from different providers and EHR systems must be matched, deduplicated, and analyzed as a cohesive dataset.
This process requires careful attention to data governance and standardization across all participating providers. Without proper integration, ACOs risk incomplete reporting and missed opportunities for shared savings.
Related: ACO Models: Which One Fits Best?
2025 Quality Reporting Revolution
MSSP ACOs will report using electronic clinical quality measures (eCQMs) or Medicare Clinical Quality Measure collection types starting in 2025, beginning to minimize the use of MIPS CQMs. This transition represents a fundamental shift in how ACOs demonstrate their performance to CMS.
Key Changes for 2025:
- All Shared Savings Program ACOs must report the APP Plus quality measure set
- Four clinical quality measures become mandatory
- The CAHPS survey remains a required component
- Readmission measures continue as performance indicators
Organizations preparing for these changes must evaluate their EHR systems’ ability to automatically extract the necessary data elements. This shift affects how ACOs approach ACO reporting strategies.
Electronic measures offer more precise data collection but require EHR systems configured to capture structured data elements consistently across all providers in the network.
Real-Time Cost Management Through EHR Analytics
EHRs provide ACOs with the real-time visibility needed to identify cost-saving opportunities before they impact shared savings calculations. When providers access current patient information, they can intervene proactively to prevent expensive complications.
High-Impact Cost Management Applications:
- Risk Stratification: Identifying patients likely to require expensive interventions
- Care Gap Analysis: Finding patients overdue for preventive services
- Utilization Monitoring: Tracking providers with excessive test ordering patterns
- Medication Management: Preventing adverse drug events and interactions
Successful ACOs leverage EHR data to identify high-risk patients, such as those with chronic conditions, frequent hospitalizations, or medication adherence issues, for targeted care management, while also tracking provider resource use to flag excessive testing or procedures and guide education and feedback that improves outcomes and reduces costs.
Population Health Management Excellence
Effective ACO management requires population-level insights that only comprehensive EHR data can provide. ACOs need to understand patterns across their entire attributed beneficiary population to develop effective interventions.
EHR systems enable ACOs to stratify their populations by:
- Risk level and chronic condition severity
- Historical utilization patterns
- Geographic and demographic factors
- Social determinants of health indicators
This segmentation allows organizations to deploy resources where they’ll have the greatest impact on both quality metrics and cost reduction.
Advanced EHR analytics help ACOs identify gaps in care across their population. They can flag patients who are overdue for preventive screenings, haven’t had their diabetes managed appropriately, or need medication reconciliation after hospital discharge.
Related: Success Stories: ACO Case Studies
Quality Payment Program Integration
ACOs participating in advanced payment models must navigate complex relationships between their shared savings obligations and broader Quality Payment Program requirements. EHR systems play a crucial role in managing these overlapping responsibilities.
Coordination Challenges Include:
- Individual provider MIPS reporting alongside ACO-level requirements
- Managing QPP exception applications for qualifying providers
- Ensuring CAHPS survey distribution reaches appropriate beneficiaries
- Maintaining accurate care team assignments across multiple reporting systems
Many ACO providers also participate in MIPS, creating additional reporting obligations that must be coordinated with ACO-level quality measures. EHR systems that can support both individual provider MIPS reporting and ACO-level quality measures provide significant operational advantages.
Technology Infrastructure Requirements
ACOs need EHR systems that support interoperability, data analytics, and automated quality reporting. The most successful organizations invest in platforms that can integrate data from multiple sources while maintaining data quality and security standards.
Essential EHR Capabilities:
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- Real-time data sharing across provider networks
- Automated quality measure extraction for regulatory reporting
- Population health analytics with risk stratification tools
- Care coordination workflows that support team-based care
- Patient engagement portals that improve satisfaction scores
- Timely updates of current required quality metrics
Cloud-based EHR solutions give ACOs centralized data access while supporting distributed care across multiple sites and provider groups, making them well-suited for collaborative models. To maximize their impact, ACOs must invest in training and change management so providers can effectively use these tools to support both individual patient care and broader population health goals.
Organizations looking to optimize their quality reporting and shared savings performance should consider partnering with specialized MIPS reporting services that understand the complex relationships between EHR data, quality measures, and payment model requirements.
Conclusion
Electronic health records are the backbone of ACO success, providing the data collection, analysis, and reporting needed for shared savings eligibility and distribution. As requirements shift toward electronic measures and population-based analytics, ACOs must ensure their EHR systems support both current needs and future regulations.
Thriving in value-based care depends on strategically leveraging these capabilities with the right processes and expertise to turn real-time data into actionable insights that improve outcomes and reduce costs.
