Health Systems
Risk contracts require risk-based operations
Converging Health helps health systems, medical groups, and ACOs build the risk intelligence, clinical workflows, and care team support that value-based contracts actually require.
Proof in practice
How one health system reduced costs by $14M in year one
A safety-net hospital system serving a high-risk Medicaid population changed how patients were identified, scheduled, and supported. Cost and utilization improvements began within three months of implementation.
Total savings
$14M
Total cost savings reported across a population of 37,318 members.
ED utilization
⬇15%
Emergency department visits declined from 671 to 571 per 1,000 people.
PMPY cost
⬇6.8%
Average annual cost went down 6.8%, from $5,102 → $4,749
Speed of change
3 mo.
Cost and utilization trends began moving down earlier than anticipated.
Value-based care breaks when risk stays outside the workflow
Many organizations take on risk contracts while daily operations stay fee-for-service. The contract pays for managing risk across a population. The workflow still revolves around whoever is on today's schedule.
The result is predictable. Rising-risk patients stay invisible until they arrive in the ED. Care gaps sit open because no one owns follow-through between visits. Panels are managed one appointment at a time, and reporting arrives months after the opportunity to act has passed.
This reflects an operating model built for volume being asked to deliver on risk.
The 5 pillars of practice transformation
Sustained value-based performance requires more than a risk score. Converging Health's clinical transformation work is built on 5 pillars.
1
Mindset
shift
Moving care teams from reacting to visits toward proactively managing panels and risk.
2
Data management
Making risk intelligence accurate, current, and usable inside real clinical workflows.
3
Process optimization
Redesigning outreach, visit preparation, and follow-through around the patients who need them most.
4
System support
Giving care teams the tools, reporting, and coordination support to sustain the model day to day.
5
Vertical integration
Connecting primary care, specialty care, and the broader system so patients move through coherent pathways.
From insight to action
Converging Health changes what care teams see, prioritize, and do each month.
1
Identify who is rising in risk, and why
The Whole Person Risk Score looks beyond diagnoses to care quality, engagement, and follow-through, so care teams see which patients are moving toward avoidable events while there is still time to act.
2
Activate members with high-value visits
Monthly outreach prioritization, high-value visits, and panel-level visibility give care teams a concrete answer to the hardest operational question in value-based care: who needs us this month?
3
Measure the risk migration
Risk migration analytics, practice report cards, and governance reporting show whether outreach, visits, and pathway work actually moved risk, utilization, and cost. Leadership sees performance, not just activity.
Start with a simple conversation
Taking the first step is easy. We typically ask a few practical questions about your population, cost pressures, current programs, and what you want to improve.
From there, we can help you see where Converging Health may fit, where the biggest opportunities may be, and what information would be needed to evaluate potential savings.