Your analytics tell you who needs attention. Your care management program tracks the work. The gap is getting it done — at the scale of your attributed panel, across a full performance year, without adding coordinator headcount you don’t have budget for.
Request a DemoMSSP ACOs and risk-bearing MSOs operate with a clear financial equation: shared savings depend on keeping total cost of care below benchmark, which depends on care management execution quality. The data to identify the work is usually adequate. The execution infrastructure to complete it at panel scale is not.
Industry data consistently shows that manual outreach reaches fewer than 30% of eligible patients within the 24–48 hour window. The missed patients are the ones most likely to return to the ED — and most likely to drive readmission costs against your TCOC benchmark.
ZynGap identifies the gaps. Closing them before the performance year ends requires outreach, scheduling, visit completion, and documentation alignment that coordinator capacity cannot sustain at full-panel scale. Most ACOs leave RAF score on the table at year-end.
Care coordinators carry the full execution load of value-based care programs. The patient-to-coordinator ratio means some work doesn’t get done — not because the team isn’t working, but because the volume requires an execution layer, not more headcount.
CCM billing represents significant unrealized revenue for ACOs with chronic disease panels. Capturing it requires consistent monthly patient contact and billing-ready documentation that most coordinator teams cannot sustain at scale.
Zynix AI carries the execution volume that care management programs generate but coordinator teams cannot sustain. It operates at the intersection of your intelligence layer and your patient population — completing the work the analytics identify.
Every patient on the follow-up list gets contacted. Every CCM-eligible patient gets a monthly touchpoint. Every HCC gap gets an outreach trigger. The care team handles clinical escalations — Zynix AI handles the volume.
The HCC + Quality Gap Closure Sprint coordinates outreach, scheduling, and documentation on a performance-year timeline — prioritizing by RAF impact and closure window. Programs don’t stall in Q4 when coordinator bandwidth is already stretched.
Predictive signals on rising-risk and readmission-risk patients trigger outreach before the clinical event. Barrier capture routes resolution through the same interaction. The cost that doesn’t happen is the shared savings that does.
Every non-emergent ED visit by an attributed patient is a direct hit to TCOC. Consistent after-hours access — clinical triage, self-care guidance, next-day scheduling — keeps routine care needs from defaulting to the ED.