Customer story
West Florida ACO, an MSSP ACO, uses the Zynix data foundation, outreach agents and risk analytics to find open care gaps sooner and work them across its practices.
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Segment
ACO
Program
Medicare Shared Savings Program
Workflows
Gap closure, wellness visits, post-discharge follow-up
The challenge
West Florida ACO manages a growing attributed population under the Medicare Shared Savings Program. Gap worklists came from quarterly claims refreshes, risk adjustment coding lagged behind encounter volume, and each practice ran its own outreach, so patient engagement varied across the network.
Workflows
One data layer and one outreach process for the whole network, with the ACO’s care team deciding who needs a clinician.
Zynix
Brings claims and clinical data together and updates gap lists as new data arrives.
ACO team
The ACO’s quality team reviews suspected HCCs.
Agent
Reaches patients for gap closure, wellness visit scheduling and post-discharge follow-up, for every practice from one queue.
ACO team
Care coordinators take the patients the agent routes to them.
Zynix
Flags patients whose risk is rising.
ACO team
Care managers decide how and when to reach them.
Care management Demo Sample data
Open care gaps
All practices · updated today
Pt 1042 · Annual wellness visit due
Practice 3
Outreach agent
Booked
Pt 2288 · Suspected HCC to review
Practice 1
Care coordinator
Review
Pt 3175 · Diabetic eye exam open
Practice 5
Outreach agent
In progress
Pt 1520 · Colorectal screening open
Practice 2
Outreach agent
Queued
Agents work routine outreach; suspected HCCs go to the quality team.
Illustration of the workflow with sample data. Not West Florida ACO patient data.
Before and after
What changed at West Florida ACO
Workflow
Before
With Zynix
Gap lists
Refreshed quarterly from claims.
Updated as claims and clinical data arrive.
Outreach
Run separately by each practice.
One queue for the whole network.
Rising risk
Identified from periodic reports.
Flagged for care managers for proactive follow-up.
More customer stories
Palm Beach ACO Customer story · ACO →
Central Florida ACO Customer story · ACO →
Built for
ACOs TCM, AWVs, HCC and quality gaps →
Products
Data foundation Claims, EHR, ADT and labs, unified →
Analytics Risk, quality and HCC gaps →
We’ll show the workflows West Florida ACO uses, on sample data, and what it would take to run them in your organization.