HSG ACO/IPA Management Service Offerings 

HSG offers three levels of ACO/IPA support designed to meet your organization where it is and elevate performance through hands-on strategy, operations, and provider engagement. Whether you need a high-level advisor or a full-service implementation partner, our team brings the expertise, insight, and executional muscle to help your ACO thrive in MSSP and beyond.

HSG is proud to offer three levels of ACO management options. 

  • ACO Comprehensive

  • ACO Advanced 

  • ACO Core 

Below is a more detailed breakdown of the service levels and HSG's approach to completing them. The minimum starting engagement timeline is 9 months. The proposed timeline could be changed, but a more rapid one might require HSG to retain additional resources, raising the cost.

ACO Comprehensive

  • HSG acts as the ACO’s embedded transformation partner and is responsible for strategic direction, operational execution, and performance. At this level, HSG functions as an extension of the executive team, driving continuous improvement across all dimensions of ACO operations.

    Key Inclusions:

    • Strategic lead for ACO direction, growth, and positioning within MSSP and future models (e.g., AHEAD, REACH).

    • Own all operational workstreams, including attribution management, reconciliation readiness, and compliance tracking.

    • Developing and managing a performance dashboard aligning quality, fiscal, and provider engagement goals.

    • Direct oversight and coaching of the ACO team, including developing a staffing matrix, job descriptions, and hiring/onboarding support.

    • Complete management of provider communication, including content drafting, calendar creation, and approval workflows.
      Hands-on support with HEC data flows, including data cleaning, analysis, and presentation to providers.

    • Advanced financial and risk modeling: forecast shared savings, model benchmark performance, and drive clinical optimization.

    • ACO-wide provider engagement strategy, including coaching and deployment of the HSG team to support practice improvement.

    • Participation in and leadership support for all committee and board meetings.

    • Meeting cadence:

      • Two 60-minute working sessions weekly

      • Weekly 60-minute strategic leadership meeting

      • Attendance at all committee and board meetings

      • Additional ad hoc meetings as needed

ACO Advanced

  • HSG serves as a hands-on partner to help guide and support ACO leadership and staff, focusing on optimizing operations and scaling performance improvement efforts.

    Key Inclusions:

    • Strategic advisor on track selection, risk design, and annual ACO structure decisions.

    • Support in drafting and refining strategic plans (3, 6-month, and annual PY plans), including facilitation of provider input sessions.

    • Development of a communications framework and coaching ACO staff on execution; HSG reviews and advises on all materials.

    • Data analysis and summary development using CMS and HEC data, with coaching for staff on interpretation and provider-facing rollout.

    • Risk adjustment coaching and benchmarking guidance; HSG supports modeling, but the client leads execution.

    • Targeted provider engagement strategy development and oversight.

    • Participation in committee and board meetings upon request.

    • Meeting cadence:

      • Two 60-minute working sessions weekly

      • Weekly 30-minute leadership meeting

      • Committee participation as needed/requested

ACO Core

  • HSG provides strategic direction and selective technical support to reinforce ACO operations. This level is designed for organizations with internal capacity that would benefit from external guidance and targeted expertise.

    Key Inclusions:

    • Ongoing advisory support on MSSP strategy, track selection, and PY design options.

    • Review and feedback on ACO communications, data strategy, and risk adjustment plans.

    • On-demand technical assistance for provider engagement challenges and operational troubleshooting.

    • Analysis of prior-year data with high-level insights to support forward-looking strategy.

    • Guidance on CMS/HEC data utilization and vendor platform performance.

    • Periodic support on strategic plan development and provider engagement efforts.

    • Limited participation in committee meetings as needed.
      Meeting cadence:

      • One 60-minute working session weekly

      • Biweekly 30-minute leadership check-in

      • Committee meetings as requested

Why HSG?

End-to-End ACO Experience

HSG has supported ACOs from application and launch through annual performance evaluation, reporting, and strategic repositioning across CMMI models.

Data-Driven Insights

HSG has leveraged Medicare and ACO-specific datasets to build custom playbooks, forecast performance, and identify actionable levers to improve financial and clinical outcomes.

Operational Alignment

HSG brings deep expertise in operational execution, with a unique ability to seamlessly integrate regulatory requirements into real-world provider workflows, technology systems, and patient engagement strategies. Our team excels at aligning clinical operations with CMS program expectations to drive consistent, high-impact results.

Strategic Guidance

HSG supports ACO leadership in model decision-making, readiness planning, and compliance management to position them for long-term sustainability and performance.

Key Areas of Support

Attribution & Provider Panel Management

  • Review and validate attribution rosters and logic to ensure alignment with model goals and performance expectations.

  • Benchmark provider performance and assess the impact of provider mix on financial and quality outcomes.
    Recommend strategic inclusion or removal of provider TINs/NPIs to optimize aligned revenue and risk-bearing capacity.

ACO Performance Monitoring & Financial Optimization

  • Evaluate financial tracking tools and recommend workflow enhancements to improve transparency and responsiveness.

  • Analyze cost drivers, utilization trends, and coding patterns to identify opportunities for improvement.

  • Develop KPIs and dashboards to support ongoing monitoring and executive decision-making.

Customized M-FFS Performance Playbook

  • Create tailored playbooks incorporating model-specific benchmarks, risk levers, and operational best practices.

  • Highlight CMMI methodologies and performance levers to inform strategic planning and tactical execution.

Risk Adjustment Strategy

  • Conduct retrospective claims and risk analyses to identify underperformance or coding gaps.

  • Apply model-specific RAF methodologies to maximize risk accuracy and ensure compliance.

  • Partner with ACOs to embed improved coding practices into provider workflows.

Compliance & CMS Reporting

  • Monitor REACH and MSSP milestones to ensure timely reporting and audit readiness.

  • Support in compiling and submitting model-required documentation.

  • Track CMMI changes and translate evolving guidance into operational updates.

Technology and Infrastructure Support

  • Support vendor evaluation and tech stack decisions to strengthen data flow and analytics capabilities.

  • Ensure integration of new tools with existing systems to enhance participant usability.

Provider Engagement & Clinical Transformation

  • Analyze provider engagement models and communication workflows.

  • Support the development of shared savings strategies and quality improvement initiatives.

  • Foster trust through transparent performance feedback and targeted coaching.