Results: MIPS & ACO
What happens when practices understand their data and act on it.
Most practices can't see where they actually stand on MIPS, ACO participation, or the mandatory accountability models ahead. Here's what changes when they can.
Every client since 2020 is still with us, unless they retired, got acquired, or stopped billing Medicare.
Case Study · Pain Management
From a 9% penalty to a positive incentive: an $850,000 swing.
The Situation
A high-volume pain management practice had absorbed MIPS penalties for years, treating them as an unavoidable cost of doing business. Their leadership assumed that because the specialty is complex, high scores were simply out of reach through their EMR.
What the Data Revealed
The practice wasn't failing. Their tools were. The EMR's built-in reporting offered a few generic measures that didn't fit a specialized practice. The doctors were doing the work, but they were being graded on a limited menu of metrics that ignored their best clinical outcomes.
What Changed
Reporting beyond the EMR
We used their existing data to report specialized measures their EMR didn't offer. No change to how the doctors practice.
Finding the hidden value
High-level clinical work was already documented in their charts. We mapped it to the policy requirements it satisfied.
Doctors stayed in the exam room
We handled the backend translation so their expertise was finally visible to CMS.
The Outcome
The practice moved from the penalty tier to a positive incentive, an $850,000 turnaround. The infrastructure is permanent: it protects their revenue every year, and their focus stays on patients instead of penalty recovery.
More Results
The same pattern holds across very different specialties.
An internal medicine physician wanted to stay independent but felt the strain of unrewarded patient management.
He was already providing comprehensive care. His clinical effort was invisible to traditional billing.
Joining the VBCA ACO turned that existing work into a $68,000 revenue increase in year one.
A solo physician faced a 9% MIPS penalty simply because he had no back-office team.
He was a good doctor being penalized for reporting invisibility, not for care.
The platform took the administrative load off his desk. Total revenue swing: 11%.
A mid-sized surgical group was failing MIPS on software that offered only one-size-fits-all measures.
Their clinical excellence in surgery was ignored by generic reporting tools.
We mapped their data to high-value, specialty-specific measures. Recovery: $250,000.
A practice was overwhelmed by the manual workload of a high-friction reporting vendor.
The reporting process was pulling clinicians away from their patients.
Switching to automated infrastructure produced a 148% score improvement with a fraction of the work.
What these five have in common
None of these practices changed how they treat patients. The gap was never clinical. It was between the work being done and what CMS could see. Once the reporting caught up to the medicine, the scores and the revenue followed. That is the entire premise of what we build: make the work visible, price every decision, and submit numbers that survive an audit.
Ask us which of these cases looks like yours.
Every result on this page started the same way: with an honest read of where the practice stood. Tell us your specialty and your current reporting setup, and we'll point you to the case that's closest to your situation.