Value-Based Care Performance & Quality Revenue Optimization

Cascade Health ACO · Q3 2024 · 14,200 Attributed Lives

HCC Capture Rate

79.3%

▼ 2.7pp vs Target (82%)

RAF Score Gap

-0.11

$1.58M revenue at risk

Shared Savings Index

0.94

On track for distribution

Quality Measure Rate

87.2%

Tier 3 threshold: 85%

Care Gap Closure

71.4%

+4.2pp vs Q2

VBC Revenue YTD

$8.2M

96% of projection

Quality Measure Performance vs. Tier Thresholds

Shared Savings Utilization Index — Monthly PMPM Trend

Avoidable Utilization Rate

RAF Score Completeness

Current: 0.89 | Target: 1.00

Attribution Stability

93.7% retained quarter-over-quarter

Coding Query Response Rate

Target: >85% within 48h

Care Gap Closure Heatmap — by Care Manager × Measure Domain

Diabetes

HTN

Cancer Scr

Immuniz

Behavioral

AWV

J. Martinez

88%

91%

76%

83%

68%

94%

A. Chen

92%

89%

87%

79%

71%

91%

R. Patel

74%

85%

69%

88%

58%

77%

K. Williams

86%

90%

82%

85%

73%

89%

D. Thompson

81%

78%

84%

86%

65%

93%

VBC Revenue Accrual Waterfall — Q3 YTD

HCC Capture Rate by Condition Category

Value-Based Contract Detail Table

Contract	Payer	Lives	Model	Quality Tier	YTD Revenue	At-Risk Bonus
MSSP Track 1+	CMS	6,840	Shared Savings	Tier 3	$3,240,000	$420,000
MA - Humana	Humana	3,120	Risk-Adjusted Cap	Tier 2	$2,880,000	$180,000
MA - UnitedHealthcare	UHC	2,680	Risk-Adjusted Cap	Tier 3	$1,920,000	$240,000
Commercial ACO	Premera	1,220	Shared Savings	Tier 2	$680,000	$54,000
PCMH - Regence	Regence	340	PMPM + P4P	Tier 3	$480,000	$38,000