Independent Primary Care ACO Optimizes AWV Completion Rate

Accountable Care Organizations (ACO) have proven to be one of the most effective approaches for improving quality and lowering the cost of care for patients (1). However, ACOs still struggle with coordinating care team activities such as closing care gaps and leveraging care coordinator resources across multiple providers and practices across multiple sites. As a result, care team activities that have the most impact on value-based contract performance are not easily prioritized and lack traceability.

Pathio was built to optimize the performance of clinical care teams operating under value-based care (VBC) payment models. One such activity is conducting Annual Wellness visits for patients. For primary care providers, one of the most important and successful activities a clinic can do to improve their quality measure scores and lower costs is completing Annual Wellness Visits (AWV) for their attributed patient population (2).

We conducted an analysis of a pilot with an independent primary care ACO, which used Pathio to identify, track, and complete Annual Wellness Visits. Over the course of just 6 months, their AWV completion rate increased from 50% to 81%.As a direct result of this improvement, patient attribution improved and the “quarterly churn” of patient empanelment was reduced to 0.5%. This single effort led to an increase in over $10,000 per provider in annual value-based revenues.

What is Pathio?

  • Pathio is a care collaboration platform for care teams to easily incorporate ACO, clinical, and payer data (in any format) to identify, address, and close care gaps for their patient population.
  • We allow care teams to organize and prioritize the work that matters most for their patients and for their practice.
  • We provide real-time visibility into the performance of care teams for closing of care gaps, quality measure improvement campaigns, and other value-based care activities.
  • We provide pre-built campaign toolsets that align directly with the requirements of VBC programs such as Primary Care First, CPC+, and Shared Savings Accountable Care Organizations

What makes Pathio different?

  • Web-based SaaS platform can be quickly implemented – averaging less than 4 weeks from signing to go-live.
  • Interconnectivity for care teams that work together within or beyond the same four walls.
  • Our “no-code” development platform supports customizable workflow automation, reducing IT resource needs.
  • Flexible contracting and low entry price point.

Interested in learning more? We would love to talk to you. Please send us a message at

  1. ACOs, Population-Based APMs Most Effective at Lowering Costs, Rev Cycle Intelligence, Nov 2020
  2. Medicare Annual Wellness Visit Association with Healthcare Quality and Costs, The American Journal of Managed Care, March 2019, Volume 25, Issue 3