CASE STUDY
Mabel helps ACO REACH grow its aligned lives by 30% in 1 year
THE CHALLENGE
Mabel's analysis across 100,000+ Medicare fee-for-service (FFS) lives reveals that typically only ~40% of provider panels are claims-aligned. As a result, voluntary alignment represents a substantial opportunity for ACO REACHs to increase their aligned lives, grow revenue, and better support their participating providers.
Voluntary alignment is the process that lets Medicare fee-for-service (FFS) beneficiaries select, or “voluntarily align” with, a primary clinician. This attestation can be completed via paper form or electronically. However, successfully executing voluntary alignment across a large provider network poses several significant challenges:
Voluntary alignment needs a multi-channel approach. Relying on collecting forms in individual clinics is administratively challenging and rarely yields net-new alignments—as patients who visit the office frequently are often already claims-aligned. Using the provider’s EMR data to mail and email forms on behalf of the practice is the most effective and fastest way to gain new alignments, but is cumbersome to execute at scale.
Response processing requires lots of resources and is error-prone. Processing voluntary alignment forms for CMS submission is slow, tedious, and requires a large, highly focused team. Without rigorous quality control measures and an underlying technical solution, partners have cited up to 50% of submissions being rejected due to preventable errors, such as mistyped MBIs and TIN-NPI errors.
Analytics help optimize campaign success. Without an overarching analytical platform, there is no real-time visibility into the status of voluntary alignment efforts—including % of unaligned patients in each practice, # of SVAs received, and forecasts for net new alignments. This makes it challenging for both practices to focus efforts on unaligned patients as well as for management to forecast growth.
THE SOLUTION
Mabel is a turn-key solution that helps leading ACO REACH organizations grow their alignments. Mabel handles all aspects of voluntary alignment, including campaign execution, response processing, alignment tracking, and auditing—taking the administrative burden off of providers and ACO administrators.
Mabel helped this ACO REACH grow its aligned lives by >30% in 1 year
Net-new alignments (A0) over 12 months
Campaign execution
Mabel uses EMR data and the alignment files to determine which patients are unaligned, and then mails and emails personalized, pre-populated voluntary alignment packets on behalf of the practice. Mabel also creates pre-filled, practice-specific paper forms along with QR codes for clinic staff to use in the practice.
Response processing
Mabel processes the signed forms that are completed across all channels — mail, email, QR code/web, and in clinic. Mailed forms are sent directly to Mabel’s processing center via a prepaid envelope where they are opened, scanned, and processed through our technology platform. All signed forms are stored for 10 years.
Alignment tracking & submission
The Mabel Dashboard provides real-time visibility into the performance of voluntary alignment efforts across all channels, allowing the ACO REACH team to focus their efforts on providers that needed more support. The Mabel Dashboard also allows the team to track their performance each quarter, allowing regular reports to executive management.
Click below to learn more about Mabel’s technology platform for ACO REACH.
We previously handled voluntary alignment and beneficiary notification letters in-house, but it required a large team, was a huge headache, and resulted in a number of errors. Mabel has made these processes a lot easier and effective, so our team can focus on strategic tasks.
— Large ACO REACH
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