AI-Powered ACO REACH Operations
Automating Attribution, Engagement, and Performance Management for ACO REACH Participants
Strengthen beneficiary attribution and voluntary alignment workflows
Strengthen beneficiary attribution and voluntary alignment workflows
Monitor quality measures and financial benchmarks in
real time
Production-ready in 4-6 weeks - not 6-12 months
The Ally Advantage
CareAlly helps ACO REACH participants manage the operational complexity of population-based, two-sided risk arrangements. From attribution management to beneficiary engagement to quality reporting, CareAlly automates the workflows that determine whether an ACO generates shared savings or absorbs losses.
With PY2026 bringing tighter risk score caps, narrowed risk corridors, and a quality withhold increase from 2% to 5%, operational precision has never mattered more. CareAlly gives your team the tools to execute at scale without adding headcount.
Why We're Different
Attribution Management Ingest beneficiary rosters, validate alignment status, and flag attribution changes before they impact your benchmark calculations.
Automated Engagement PeopleAlly delivers 24/7 outreach across text, voice, and email in 120+ languages, keeping aligned beneficiaries engaged and connected to their care teams.
Quality Measure Tracking Monitor performance against ACO REACH quality metrics with automated dashboards that surface gaps before they affect your withhold earn-back.
Claims and Denial Support
ClaimsAlly audits, corrects, and prepares denied claims for resubmission, protecting revenue in a model where every dollar affects your shared savings calculation.
Risk Score Integrity Automated documentation review and coding validation help ensure your risk scores reflect actual patient acuity, critical under V28 and the new cumulative growth caps.
LEAD Transition Ready CareAlly is already building the operational workflows for LEAD, launching January 2027. Organizations that operationalize with CareAlly today will have a direct path into the 10-year successor model.
The Problem
ACO REACH demands that participating organizations manage total cost of care for attributed Medicare beneficiaries while meeting quality benchmarks, all under two-sided financial risk. Most ACOs are doing this with spreadsheets, manual outreach, and disconnected systems. The result: missed attribution windows, inconsistent beneficiary engagement, coding gaps that suppress risk scores, and quality shortfalls that erode the withhold earn-back.
CMS is tightening the model in PY2026 with cumulative risk score caps, narrowed risk corridors, and a quality withhold increase to 5%. At the same time, organizations need to start planning their transition to LEAD before applications open in March 2026. The operational lift is significant, and manual processes cannot keep up.
The Solution
CareAlly automates the core operational workflows that drive ACO REACH performance. Attribution management, beneficiary engagement, quality gap closure, claims processing, and compliance reporting all run through a single platform, with PeopleAlly providing always-on outreach to your aligned population. For organizations already in ACO REACH, CareAlly reduces the administrative burden of managing population-based risk.
For organizations evaluating LEAD participation, CareAlly provides the operational infrastructure to enter the model with confidence. Provider Partners is already piloting CareAlly's ACO REACH capabilities, building the playbook for scalable, AI-assisted accountable care operations.