At-Risk Providers & ACOs
You Took on the Risk. Are You Getting the Return?
Value-based contracts promise shared savings and better outcomes, but only if your attributed population gets the care they need, within your network, before costs spiral.
What’s Quietly Draining Your Shared Savings
- Attributed patients with unmanaged chronic conditions or missed preventive care are your highest-cost events waiting to happen — hospitalizations, ER visits, and avoidable readmissions that directly hit your performance.
- Attribution leakage is real. Patients who can’t access care within your network seek it elsewhere — and those costs follow them back to your ledger.
- Advanced APM and MSSP benchmarks are tightening. The cushion that existed in early value-based arrangements is gone. Every gap in care that goes unaddressed is shared savings that won’t materialize.
- Your risk stratification data tells you who’s at risk. But knowing and acting are two different things — and most care coordination teams don’t have the capacity to close the gap at scale.
Care Coordination That Actually Closes the Loop.
ReferWell gives at-risk providers and ACOs the infrastructure to turn care management intelligence into completed appointments, keeping attributed patients healthier, more engaged, and within your network.
Through ReferWell Engage™, our Care Navigators work as an extension of your team, handling outreach, navigating patient barriers, and booking appointments with the right in-network providers. ReferWell Connect™ closes the loop on referrals from order through specialist visit note, ensuring every referral becomes a kept appointment.
We’re not a referral platform. We’re the human-led, tech-enabled layer that makes your value-based model actually work.
Built for Value-Based Performance
80%
To kept appointments.
85%
In-network Referrals.
<1 min
vs. 5-20 minutes prior
How It Works
Your care management team or risk stratification tool surfaces high-priority, high-risk patients.
ReferWell Care Navigators conduct proactive, personalized outreach — reaching patients others can’t.
Patients are scheduled with the right in-network provider in under one minute, with barriers like transportation, language, and availability addressed in real time.
Network stewardship is reinforced — patients stay in-network for continuity and cost control.
Transitions-in-care engagement available within 24 hours of discharge when HIE data is provided.
Closed-loop reporting documents completed visits and correlates outcomes to your VBC performance metrics.
you’re making right now.
The plans that perform in value-based care are the ones that act before costs compound.