Value-based care is a quality strategy.
Unity makes it one.
Most organizations leave 30–40% of their VBC performance on the table. Unity's AI engine works continuously across quality, risk adjustment, care gaps, and shared savings — delivering $1M+ in measurable annual clinical and quality impact for a 10-provider clinic.
Why organizations consistently underperform in value-based care
VBC contracts are complex — quality thresholds, risk adjustments, shared savings calculations, and care gap requirements that interact across dozens of payers simultaneously. Without AI, human teams simply can't monitor and act on this data fast enough to capture the full opportunity.
Invisible Care Gaps
42% of care gaps go unaddressed between visits because no one is monitoring them continuously. Each missed HEDIS measure costs $2,000–$18,000 in payer incentives — every year.
Undercaptured HCC Risk
Most clinics capture only 72–75% of their HCC coding opportunity. The gap between actual and documented risk adjustment represents $300K+ in annual Medicare Advantage value for a 10-provider clinic.
Contract Blind Spots
Organizations discover threshold breaches only after reconciliation — when it's too late to act. No early warning, no intervention window, and missed shared-savings distributions that can't be recovered.
Five pillars of VBC performance
Unity's AI engine works continuously across every dimension that determines your value-based care performance — not just at reporting time.
Quality Scores & HEDIS Performance
AI continuously monitors 245+ quality measures across MSSP, Medicare Advantage, commercial VBC, and UDS. Every open care gap is identified, prioritized, and assigned to care team worklists — daily. Organizations using Unity improve average quality scores by 17+ percentage points within 12 months.
Risk Stratification & Complex Care
Not all high-risk patients are equally at risk for costly outcomes. Unity's AI stratification engine scores every attributed patient by clinical complexity, social risk factors, utilization history, and predicted trajectory — ensuring care management resources are concentrated on patients most likely to drive avoidable costs.
Care Gap Identification & Closure
Unity identifies, tracks, and helps close every open care gap across your entire attributed population — 24 hours a day, seven days a week. AI-generated outreach campaigns target the right patients for each gap through their preferred channel, achieving a 68% response rate versus the 22% industry average for manual outreach.
Member Engagement & Retention
Attributed member engagement is the foundation of every VBC program. Unity's AI engagement engine reaches every patient proactively — AWV scheduling, gap closure outreach, preventive care reminders, and chronic disease follow-up — achieving 3.4× the patient reach of manual workflows with 80% less staff time.
Performance Reporting & Analytics
Real-time dashboards and payer-specific scorecards give leadership the visibility they need to make strategic decisions — not just quarterly reports. Unity provides live tracking of HEDIS measures, quality scores, care gap closure rates, risk adjustment performance, and contract thresholds — all in one view.
$1M+ in annual clinical and quality impact
Modeled for a 10-provider primary care clinic with 8,000 attributed patients across MSSP, Medicare Advantage, and Medicaid VBC programs.
HEDIS performance bonuses, CMS Star rating improvements, and payer quality incentive payments recovered through AI-driven gap closure and measure monitoring.
- +17% average quality score improvement
- 87% care gap closure rate
- CMS Star rating: 3.5 → 4.2
- 245+ measures monitored continuously
Prospective HCC coding improvement and risk adjustment across Medicare Advantage and VBC contracts — supporting accurate, complete documentation of diagnoses at the point of care.
- +17% RAF score improvement
- HCC capture rate: 72% → 92%
- 3,200+ HCC gaps identified/year
- 98% RADV audit readiness
MSSP and VBC contract shared-savings distributions protected and enhanced through real-time threshold monitoring, early warning alerts, and network cost management.
- Zero threshold breaches
- −42% network leakage reduction
- 48-hr early warning before breach
- 100% contract visibility
$109K in annual cost savings
Unity doesn't just improve performance — it eliminates the administrative burden that prevents your clinical team from practicing at the top of their license.
Per 10-provider clinic. Derived from staff time recaptured from manual outreach, care gap tracking, HCC documentation, and contract monitoring workflows.
AI handles data aggregation, measure calculation, and payer scorecard generation — freeing care coordinators to focus on patients instead of spreadsheets.
Time Recaptured by Category
Before and after Unity
How a 10-provider primary care clinic transforms its VBC performance with Unity PHM in the first 12 months.
| Performance Area | Before Unity | After Unity |
|---|---|---|
| Average Quality Score | 68% | 85% +17% |
| Care Gap Closure Rate | 58% | 87% +29% |
| HCC Capture Rate | 72% | 92% +20% |
| RAF Score (MA patients) | 1.21 | 1.42 +17% |
| AWV Completion Rate | 62% | 88% +26% |
| In-Network Referral Rate | 76% | 94% +18% |
| Patient Outreach Response Rate | 22% | 68% +46% |
| No-Show Rate | 18% | 11% −7% |
| Staff Reporting Hours/Wk | 28 hrs | 8 hrs −70% |
| Time to ROI | 12–18 months | 90 days Faster |
Every value-based care program, supported
Medicare VBC Programs
- MSSP / Next Gen ACO
- Medicare Advantage Quality
- CMS Innovation Models
- MIPS / APM Reporting
Medicaid Programs
- Medicaid MCO Quality
- State P4P Programs
- CHIP Quality Measures
- UDS / HRSA Reporting
Commercial VBC
- Shared Savings / Risk Contracts
- Bundled Payment Programs
- Capitation / Global Risk
- Payer Quality Incentives
Quality Frameworks
- HEDIS Measures
- NCQA / PCMH
- CMS Star Ratings
- JCAHO / TJC Quality
Real organizations. Measurable outcomes.
"Unity transformed our MSSP performance. We went from missing our quality threshold by 4 points to exceeding it by 11 — and that difference was worth $290,000 in our reconciliation check. The ROI was obvious within the first six months."
What's your VBC improvement potential?
Let's calculate it together.
In a 20-minute discovery call, our team will model the specific improvement opportunity for your organization's payer mix, attributed population, and quality baseline.
No commitment required · Results in 90 days or your money back