This whitepaper breaks down why network leakage costs ACOs far more than the revenue lost on any single out-of-network encounter, and why the standard approach of monitoring claims data is structurally too late to fix it.
The core problem is timing. Claims data arrives six to eight weeks after care is delivered. By then, the encounter has happened, the episode has started, and the cost is locked in. Organizations managing leakage through claims are always solving last quarter’s problem.
The whitepaper covers what that data lag costs beyond revenue, including how out-of-network encounters erode HCC benchmarks, leave care gaps open, drive duplicate imaging, and increase preventable readmissions. It traces where leakage typically originates, which is not specialty referrals but primary care, months before a specialist is ever involved, and explains why primary care leakage carries a consequence that post-acute leakage does not: the risk of losing attribution entirely.
It also covers the operational levers that move the needle, from Annual Wellness Visit (AWV) completion and chronic disease follow-ups to referral infrastructure and patient communication, and what it looks like when clinical and claims data are unified into a single, real-time view of the attributed population.
Download this whitepaper to understand what separates ACOs that prevent leakage from those that keep measuring it, and what infrastructure is required to make the difference repeatable at scale.