The Data You Get and Need

An ACO cannot manage what it cannot see, and no single source shows it everything. The data foundation of an ACO is assembled from several feeds, each with different strengths, and understanding what each one offers is the starting point for the whole analytics stack.

What a Medicare ACO receives

A major advantage of a Medicare ACO is that CMS shares claims data on its attributed beneficiaries. This is the data the finance and Medicaid courses described: complete across settings, structured, and population-wide.

Worth remembering: claims data is the ACO’s superpower and its frustration at the same time. Because claims follow the patient everywhere, they reveal the admission at the hospital across town, the specialist the ACO never referred to, and the post-acute stay no one told the primary care doctor about, the leakage and utilization the ACO’s own records cannot see. But claims arrive with the lag from the finance course, so they show where the money went, not what is happening today.

What the ACO must add

Claims alone are not enough to manage patients in real time. A functioning ACO layers on:

• EHR and clinical data from its own providers: lab values, vital signs, problem lists, the clinical detail claims lack.
• ADT feeds (admission, discharge, transfer): the near-real-time alerts, highlighted in the intro course, that tell the care team a patient is in the hospital now, while there is still time to act.
• Supplemental and social data where available, to round out risk.

Assembling the picture

The ACO’s job is to fuse these into one view of each patient and the whole population:

Source	Strength	Limit
Medicare claims	Complete across all settings	Lags weeks to months; clinically thin
EHR / clinical	Rich clinical detail	Only the ACO’s own care
ADT feeds	Near real time	Narrow; needs a team ready to act

Neither claims nor clinical data alone is sufficient. Claims give the complete but late picture; clinical and ADT data give the timely but partial one. The ACO that manages well is the one that combines them so the right information reaches the right person in time, the last-mile problem the Medicaid course named.

Key takeaways

• A Medicare ACO receives CMS claims data showing its patients’ care across every setting, its key visibility advantage.
• Claims lag and lack clinical detail, so the ACO adds EHR data and, crucially, near-real-time ADT feeds.
• The analytics job is to fuse complete-but-late claims with timely-but-partial clinical data into one actionable view.