ACO Risk Adjustment Built for Value-Based Care

Achieving strong results in ACO REACH and MSSP requires accurate risk identification, complete documentation, and seamless data connection across diverse care settings.

3Gen Consulting delivers integrated ACO risk adjustment and HEDIS abstraction solutions that help organizations elevate Medicare ACO REACH performance, strengthen compliance, and improve shared savings across their attributed populations.

Optimize My Performance

Capture Risk

Ensure complete HCC identification to support accurate ACO benchmarks.

Boost Quality

Close MIPS and HEDIS gaps to strengthen overall ACO performance and quality outcomes.

Unify Data

Combine claims, EMR, and clinical data to generate actionable insights efficiently.

ACO Risk Adjustment for Modern ACOs

ACOs participating in MSSP and ACO REACH programs operate within highly coordinated care models where results depend on precise ACO risk adjustment, aligned reporting, and dependable quality performance. 3Gen combines certified coders, automation, and unified data intelligence to help ACOs strengthen HCC accuracy, improve quality reporting, and drive equitable results across Medicare ACO REACH and shared savings programs.

Proven Performance Across ACO Risk Adjustment Programs

Every result reflects our commitment to improving ACO risk adjustment, enhancing quality reporting, and supporting data-driven decisions. Outcomes vary based on ACO size, attribution, and population complexity.

%+Chart Retrieval Rate

%+HCC Coding Accuracy

:1Return On Investment

%Timely Submissions

Solving Today’s Most Pressing ACO Healthcare Challenges

Success in ACO healthcare requires more than strong intent – it depends on aligned data, consistent documentation, and regulatory clarity. From multi-source records to shifting CMS rules, ACOs face numerous operational and analytical hurdles that influence ACO risk adjustment, quality reporting, and overall program performance.

Patient information spread across multiple EHRs and provider networks makes accurate ACO risk adjustment and HEDIS abstraction difficult. Seamless access to complete clinical data is essential for compliant submissions and precise risk capture.

Incomplete or inconsistent provider documentation reduces accurate HCC capture, quality reporting, and ACO REACH risk adjustment performance. Continuous provider education and documentation improvement programs are vital.

ACOs must comply with CMS rules for MSSP or ACO REACH, including risk adjustment, HEDIS measures, equity reporting, and performance metrics. Missteps can impact shared savings and population health outcomes.

When risk adjustment and quality programs operate separately, ACOs lose actionable insights. Integrated data across HEDIS and ACO risk adjustment programs drives better financial and clinical results.

Manual workflows and outdated tools slow visibility into HCC coding, quality metrics, and population trends. Intelligent automation and dashboards enable real-time tracking, gap detection, and predictive insights.

Seasonal peaks, staff bandwidth limitations, or reliance on internal coders can slow chart reviews, risk capture, and HEDIS abstraction, reducing efficiency and Medicare ACO REACH performance.

What problem can we help you solve?

Whether it’s risk, quality, or compliance, every ACO needs a strategy. Let’s tailor yours.

My Biggest Challenge isMy Solution of Interest is

Completing the Puzzle with Integrated Solutions

Technology That Transforms ACO Risk & Quality

From structured processes to AI-powered intelligence, 3Gen’s RiskGen suite helps ACOs achieve accurate HCC capture, close quality gaps, and optimize risk-adjusted performance for shared savings and MIPS, MSSP, and ACO REACH reporting.

The Precision of People.

For ACOs that prioritize human-led accuracy, structured processes, and comprehensive compliance across all risk and quality workflows.

Human-Led Accuracy: 100% coder-driven reviews with multi-level QA ensure accurate HCC capture, complete documentation, and validated HEDIS abstraction.
Structured Workflows: Proven processes ideal for smaller patient populations or organizations where AI adoption is restricted.
Compliance Confidence: Built-in MEAT/TAMPER validation and randomized audits safeguard against unsupported diagnoses, quality gaps, and CMS reporting issues.

The Power of Intelligence.

For ACOs seeking speed, scale, and predictive insight to optimize HCC coding, risk adjustment, and measurable quality and performance outcomes.

AI + Human Validation: Neuro-symbolic generative AI with coder oversight accelerates throughput while maintaining >97% coding accuracy.
Scalable Performance: Processes millions of encounters efficiently – improving HCC capture, HEDIS measure closure, and shared savings outcomes.
Actionable Insights: Real-time analytics identify documentation gaps, coding trends, and risk-quality misalignments to support proactive interventions.

Prospective Risk Adjustment

Capture conditions earlier to support better clinical planning and improved care coordination.

Concurrent Risk Adjustment

Identify HCCs in real time to guide care and reduce missed coding opportunities across the ACO.

Retrospective Risk Adjustment

Review prior-year encounters to close gaps and ensure complete ACO risk adjustment submissions.

HEDIS Quality Measure Abstraction

Extract precise data to elevate quality measures, MIPS scores, and population health outcomes.

Clinical Documentation Improvement

Educate providers to document accurately, supporting HCC capture, risk, and quality reporting.

Audit & Compliance Support

Maintain audit-ready coding and documentation aligned to CMS, MSSP, and ACO REACH compliance.

Risk Analytics, Insights & Reporting

Gain real-time insights into HCC capture, quality gaps, and population-level risk alignment.

Risk Adjustment Automation

Streamline workflows with AI to scale efficiency and accuracy across ACO risk adjustment and HEDIS.

ACO Risk Adjustment & Quality Solutions

Every value-driven ACO depends on accurate ACO risk adjustment and quality reporting to optimize shared savings and meet MSSP, MIPS, and ACO REACH requirements. At 3Gen Consulting, we deliver human-led and AI-enabled solutions – from HCC coding to HEDIS abstraction – designed to improve risk capture, documentation, and quality outcomes across the patient population, helping ACOs enhance performance and population health management.

Experience the Workflow DifferenceExperience the Workflow Difference

The 3Gen Advantage

Where expertise meets insight – powering ACO risk adjustment and quality performance across shared savings, population health initiatives, and ACO REACH program goals.

Risk Capture

Identify and code all HCC conditions to strengthen shared savings and improve MSSP and ACO REACH performance.

Quality Insights

Combine HEDIS abstraction and risk adjustment analytics to close care gaps and improve MIPS/ACO quality performance.

Compliance Confidence

Maintain audit-ready documentation and workflows to support CMS rules and ensure MSSP and ACO REACH compliance.

AI Expertise

Leverage automation with coder validation to enhance accuracy, streamline reviews, and improve risk and quality results.

Population Analytics

Use real-time dashboards and reporting to reveal trends, close care gaps, and improve outcomes across the ACO network.

Scalable Operations

Deploy flexible tech-enabled capacity to manage high volumes, seasonal peaks, and multi-provider ACO networks effectively.

The 3Gen Difference

Where Strategy Meets Results

Stop guessing. Start governing. With 3Gen, your ACO risk adjustment and quality reporting aren’t just accurate – they’re defensible, auditable, and scalable. Every HCC captured, every gap closed, every insight actionable. Turn data into decisions, workflows into wins, and risk into opportunity.

Let’s Elevate My ResultsLet’s Elevate My Results

Commitment to Compliance Excellence & Governance

At 3Gen Consulting, compliance isn’t an add-on – it’s the core of every ACO workflow we carefully deliver. From ACO risk adjustment coding to HEDIS abstraction and ACO REACH reporting, every process is built on secure, transparent, and audit-ready standards. Our dedicated compliance and quality teams ensure full alignment with CMS, MSSP, MIPS, and Medicare ACO REACH program requirements – minimizing audit exposure and safeguarding data integrity across your entire ACO network.

Proactive Compliance Oversight Programs

HIPAA & HITECH Alignment Processes Framework

Real-Time Audit Monitoring & Trails Visibility

Encrypted Data Handling & Storage Controls

FAQs

Explore answers to the most common questions ACO leaders ask when evaluating ACO risk adjustment and HEDIS partners.

Talk to an ExpertTalk to an Expert

By combining HCC coding expertise with AI-assisted analytics, 3Gen ensures every member’s risk is properly captured, helping ACOs maximize risk-adjusted payments, including MSSP and ACO REACH programs, while improving patient outcomes.

3Gen integrates HEDIS abstraction with ACO risk adjustment analytics under one platform, enabling data-driven insights across the patient population to reduce care gaps, improve quality scores, and strengthen performance in MIPS, MSSP, and ACO REACH metrics.

Through targeted clinical documentation education, actionable feedback loops, and workflow optimization, 3Gen helps providers document accurately and efficiently, reducing missed HCCs and quality measure gaps.

Yes. 3Gen provides dashboards and reporting tools that highlight trends, gaps, and high-risk populations, allowing ACO leaders to make informed care management and financial decisions.

3Gen combines AI-driven risk and quality analytics with certified coder and clinical expert review, ensuring high accuracy, compliance, and defensible results without overburdening staff.

Partnering with 3Gen gives you access to a proven, scalable, and tech-enabled solution that improves coding accuracy, optimizes quality performance, and ensures readiness for MSSP, MIPS, and ACO REACH programs – while reducing administrative burden – allowing your team to focus on care delivery and strategic growth rather than operational complexity.