Your Trusted Partner
More than an ACO.
Your healthcare business partner.
We're the team behind your team -- coordinating care, managing complexity, and keeping your patients connected to you across the hospital, the SNF, and the home.
The Reality
You can't be everywhere your patients need you.
Your patients are admitted at 2 AM. They're discharged to a SNF across town. They miss follow-ups because no one called. They struggle at home because no one checked in.
You want to provide that care. You just can't be in three places at once. That's where Pathways comes in.
What Pathways Handles
Clinical Services
Hospital & ER care coordination
Working directly with hospitalists and ER providers
SNF & post-acute care management
Recovery tracking and transition planning
Home health skilled services
Full-service home health for your patients
Care coordination & case management
Connecting every provider in your patient's care
Disease management
Proactive chronic condition management between visits
Non-emergency medical transportation
Removing barriers so patients make their appointments
Analytics & Compliance
Data analytics & performance reporting
Know exactly how your panel is doing
Quality management & reporting
We track the measures so you focus on the patient
CMS model compliance
Full regulatory and program compliance management
Practice Management
Billing & CDI
Revenue cycle management and clinical documentation improvement
Payroll & HR
Staff payroll, human resources, and health insurance
Marketing & outreach
Patient acquisition and community engagement
Our Philosophy
Better care. Stronger practices. Healthier communities.
Our mission is to empower independent physicians to deliver the kind of care they went into medicine to provide -- while building practices that thrive in a value-based world. When your practice succeeds, your patients succeed, and the entire community benefits.
Affiliate Model
Most of our network is composed of independent, affiliate practices. You keep your name, your staff, your identity. We provide the infrastructure.
All In From Day One
We operate at full risk -- the Global track. That's not bravado, it's conviction. We have the infrastructure, the data, and the team to deliver.
Business Partner
Beyond ACO services, we help with practice operations, revenue cycle, compliance, and growth. We succeed when your practice succeeds.
Our Technology
Built to outperform. Not outsourced.
While other ACOs rely on off-the-shelf analytics, Pathways built its own intelligence platform from the ground up.
ALICE
ACO Intelligence Engine
ALICE is our AI-powered clinical intelligence system embedded directly within the ACO Operating System. It transforms raw CMS claims data into actionable clinical insights -- in real time, at the patient level.
- 9-segment Comprehensive Patient Analysis
- HCC gap detection with RAF impact projections
- AHRQ PQI preventable admission identification
- Claims-based care gap detection and closure tracking
- AI-enhanced clinical recommendations
ACO-OS
ACO Operating System
The operational backbone that integrates CMS claims data, clinical workflows, financial analytics, and quality reporting into a single platform purpose-built for accountable care.
- Automated CCLF data processing and validation
- CMS benchmark reconciliation and settlement tracking
- PMPM trending and cost variance analysis
- Episode grouping with fragmentation scoring
- AWV eligibility tracking and quality dashboards
This is why we operate at full risk with confidence -- and why our partner practices benefit from insights no other ACO can match.
Experience
We've done this before.
Pathways Health Partners is an established ACO REACH participant with deep operational experience in value-based care delivery.
ACO REACH
Current CMS Participant
Full Risk
Global Track Operator
D0048
CMS ACO Identifier
AI-Driven
Advanced Analytics Platform
Let's have a conversation.
No pressure. Just answers.
We'd love to learn about your practice and share how Pathways can help you navigate the transition to LEAD.
Talk to Our Team