Ingest
Weekly CMS and ACO operating files, practice rosters, and supporting data normalized into one processing model, whatever format or timing each drop brings.
Accountable Care
Weekly ACO administration, done.
ApiVoc runs weekly CMS and ACO operations as a repeatable process: payments, 835s, NACHA, reconciliation, and practice reporting. Built for ACO REACH, ready for ACO LEAD.
The weekly burden
ACO administration is hard. We make it easy.
CMS sets the schedule. Your practice doesn't.
CMS files, ACO operating files, practice rosters, and payment data arrive every week, and rarely at the same time. Manual handling doesn't scale.
Practice payments don't run themselves
PMPM calculations, primary cap pass-throughs, and bonus payments each follow different rules, and most ACOs run mixed contract types across their participating practices.
Distribution is its own job
835s have to land in the right places, practices need clear payment detail, and exceptions need someone watching them, every single week.
The work is recurring, high-stakes, and unforgiving of mistakes.
Built for
ACO REACH today. ACO LEAD-ready.
ACO REACH organizations
Weekly execution of the operational mechanics that REACH participation demands: CMS file handling, practice payment administration, 835 and NACHA generation, and dashboard visibility for ACO leadership and practice support teams.
Preparing for ACO LEAD
As CMS transitions REACH into the ACO LEAD model, the underlying weekly operating layer doesn't go away. It gets more important. ApiVoc is designed to extend into LEAD workflows as the model matures.
The path from REACH to LEAD
One model ends, the next begins.
ACO REACH
2023 – 2026 · final year
- Professional 50% / Global up to 100%
- Monthly capitation payments
- Health equity plan & governance
ACO LEAD
2027 – 2036 · 10-year term, no rebasing
- Same risk tracks: Professional 50% / Global up to 100%
- Flexible, population-based payments
- Open to small, rural & independent practices
- Medicaid integration & patient incentives
CMS accountable care models
ACO REACH and ACO LEAD, side by side.
ACO REACH
Realizing Equity, Access & Community Health
ACO LEAD
Long-term Enhanced ACO Design
Term
Through 2026, final performance year
2027–2036 · 10 years, no rebasing
Risk options
Professional (50%) or Global (up to 100%)
Professional (50%) or Global (up to 100%)
Payments
Monthly capitation, primary or total care
Flexible capitated, population-based payments
Built for
Standard, New Entrant & High Needs ACOs
Small, rural, independent & new-to-ACO providers
High-needs care
Dedicated High Needs Population ACO track
Integrated across all ACOs · Medicaid integration
Patient incentives
Health equity plan · beneficiary governance
Engagement incentives · Part B & Part D support
Term
ACO REACH
Through 2026, final performance year
ACO LEAD
2027–2036 · 10 years, no rebasing
Risk options
ACO REACH
Professional (50%) or Global (up to 100%)
ACO LEAD
Professional (50%) or Global (up to 100%)
Payments
ACO REACH
Monthly capitation, primary or total care
ACO LEAD
Flexible capitated, population-based payments
Built for
ACO REACH
Standard, New Entrant & High Needs ACOs
ACO LEAD
Small, rural, independent & new-to-ACO providers
High-needs care
ACO REACH
Dedicated High Needs Population ACO track
ACO LEAD
Integrated across all ACOs · Medicaid integration
Patient incentives
ACO REACH
Health equity plan · beneficiary governance
ACO LEAD
Engagement incentives · Part B & Part D support
Source: CMS Innovation Center
How it works
One process, every week.
ApiVoc runs your weekly ACO administration as one repeatable, auditable process, the same five stages every week, with practice-specific contract logic built in.
Swipe diagram to explore →
Calculate
PMPM, primary cap pass-through, and bonus payments calculated from practice contract terms, including sites that run more than one model.
Generate
835 remittance files for import, NACHA files for payment execution, and reconciliation files for clearinghouse delivery, ready to run.
Distribute
Outputs routed to the right channel for each practice, with payment detail attached whether delivery is portal, clearinghouse, or direct file.
Support
Exception handling, correction workflows, weekly administration support, and dashboards so leadership and operations can see status in real time.
Recurring administration as a controlled process, not a weekly fire drill.
What you get each week
Weekly outputs, delivered.
/ 01
835 remittance files
Import-ready for practice posting.
/ 02
Payment reconciliation files
Deliverable through an ACO branded portal or clearinghouse channels.
/ 03
Practice-level payment reports
Amounts, member counts, and payment detail.
/ 04
ACO dashboards
Weekly monitoring, exceptions, and operational transparency.
Contract logic
Built for mixed contract structures.
ACOs rarely run a single contract type across every practice. ApiVoc automates the three most common payment models. ApiVoc combines them where practices participate in more than one.
PMPM
Per-member-per-month payments calculated against attributed member counts.
Primary Cap Pass-Through
Capitation amounts passed through to participating primary care practices.
Bonus Payments
Performance and quality-based payouts on the cadence the ACO defines.
Mixed across practices, executed weekly.
Scope of service
The full weekly operating layer.
Data management and file distribution
Recurring CMS and ACO operating files ingested, processed, and routed through a consistent operational model every week.
Payment management
Repeatable weekly controls for participating practices, including practices that run multiple contract types simultaneously.
Import-ready 835s
835 remittance files prepared in the format and structure practices can import directly into their billing systems.
NACHA file creation
NACHA files generated to support practice payment execution through standard ACH channels.
Dashboard reporting and support
Visibility for leadership, operations, and practice support teams, plus support services for questions, corrections, exceptions, and weekly administration.
One service. One weekly cadence. Audit-ready outputs.
Getting started
From kickoff to first weekly cycle.
Phase 1 / 01
Kickoff and configuration
Practice rosters, contract structures, file formats, and delivery channels mapped to the ApiVoc operating model. Trading partner setup with clearinghouses where needed.
Phase 2 / 02
Parallel run and validation
First weekly cycles run in parallel with existing processes. Outputs are validated, reconciliation confirmed, and exception handling tuned to the ACO's specific operational shape.
Phase 3 / 03
Production weekly operations
Full handoff to ApiVoc as the weekly operating layer. Leadership dashboards live. Support services on call for exceptions and questions.
01
Phase 1 Kickoff and configuration
Practice rosters, contract structures, file formats, and delivery channels mapped to the ApiVoc operating model. Trading partner setup with clearinghouses where needed.
02
Phase 2 Parallel run and validation
First weekly cycles run in parallel with existing processes. Outputs are validated, reconciliation confirmed, and exception handling tuned to the ACO's specific operational shape.
03
Phase 3 Production weekly operations
Full handoff to ApiVoc as the weekly operating layer. Leadership dashboards live. Support services on call for exceptions and questions.
Get started
See it run for your ACO.
We'll walk through a real weekly cycle: how your CMS and ACO files flow through ingestion, how practice contract terms get applied, what your 835s and NACHA files look like on output, and how exceptions get handled before they hit your operations team.