OnePartner Platform
How I built an in-house team and architected the technology platform that powered two ACOs to generate $180M+ in Medicare savings over a decade of value-based care.
$76M+
Total Earned Savings
Across both ACOs
$180M+
Generated Savings
Total Medicare impact
10
Performance Years
Consecutive positive years
40,000+
Peak Beneficiaries
Lives under management
The Challenge
In 2012, healthcare was fragmenting. Medicare was piloting Accountable Care Organizations, but most provider groups lacked the technology to succeed. The challenge was clear:
- ×Patient data locked in 50+ different EHR systems with no interoperability
- ×No visibility into when patients were admitted to hospitals across the region
- ×Providers flying blind on quality metrics and cost performance
- ×Care gaps invisible until they became expensive claims
- ×No infrastructure for value-based care coordination
My Role: President & Chief Architect
As President of OnePartner from 2014-2022, I was responsible for the technology vision, architecture decisions, and most importantly—building the team. Every major technical decision ran through me:
Building an Amazing Team
I was trusted to build OnePartner's technology team from the ground up. This wasn't outsourced work—it was 100% in-house development. We recruited, trained, and grew talent that could solve problems no vendor could.
In-House Excellence
- • Built entire HIE platform with internal team
- • Developed custom analytics and dashboards
- • Built repeatable EHR integration interfaces
- • Extended EHR agents with provider/patient insights
Lasting Impact
- • Team members now in leadership at major corporations
- • Alumni at health systems, tech companies, and startups
- • Skills and culture that transferred to their careers
- • Proud to see their continued success
“Nothing makes me prouder than seeing people I hired now in high-level positions at large corporations. The talent we built together went on to impact healthcare technology far beyond our region.”
ACOs Powered by OnePartner
Qualuable Medical Professionals
A220662013-2017
Coalition of 5 physician groups and 500+ providers across the Tri-Cities region
Emergent ACO
A45562019-Present
Expanded regional ACO covering Tennessee, Virginia, North Carolina, and beyond
Return on Investment
<$1.5M
Per year operating cost
$7.6M
Average earned savings/year
5x+
Return on investment
The Numbers: With less than $1.5M annual operating cost, OnePartner generated $76M+ in earned shared savings over 10 performance years—a return of over 5x the total investment. This doesn't include the $180M+ in total Medicare savings generated, quality bonuses, or the operational efficiencies gained.
Nationwide Partnership: Allscripts
The Deal
In a strategic move to expand OnePartner's reach, I traveled to Chicago to negotiate the final terms of a nationwide reseller agreement with Allscripts. This partnership would take our population health platform beyond Tennessee and Virginia to healthcare organizations across the country.
The Impact
9 States
Geographic expansion
The Allscripts partnership enabled OnePartner to onboard healthcare organizations in states where we had no prior presence, validating the platform's scalability and market fit beyond our home region.
“Going to Chicago to close that deal was a pivotal moment. It proved that what we built in Appalachia could compete—and win—on a national stage.”
Qualuable ACO Performance (2014-2017)
| Year | Beneficiaries | Savings Rate | Earned Savings |
|---|---|---|---|
| 2014 | 22,975 | 9.16% | $7.4M |
| 2015 | 21,428 | 6.07% | $5.0M |
| 2016 | 23,929 | 5.11% | $4.8M |
| 2017 | 25,481 | 3.08% | $3.0M |
| Total (4 Years) | — | Avg: 5.86% | $20.2M |
Emergent ACO Performance (2019-2024)
| Year | Beneficiaries | Savings Rate | Earned Savings |
|---|---|---|---|
| 2019 | 30,031 | 6.12% | $3.3M |
| 2020 | 32,784 | 7.21% | $8.7M |
| 2021 | 36,162 | 5.85% | $8.3M |
| 2022 | 39,650 | 6.36% | $10.2M |
| 2023 | 30,070 | 8.34% | $13.3M |
| 2024 | 26,373 | 8.19% | $12.4M |
| Total (6 Years) | — | Avg: 6.95% | $56.2M |
Decade of Performance: Combined Timeline
Combined Impact: A Decade of Value-Based Care
$76M+
Earned Shared Savings
$180M+
Total Medicare Savings
10
Performance Years
<$15M
Total Investment (10 yrs)
5x+ Return on Investment
Less than $1.5M/year operating cost → $7.6M/year average returns
Source: CMS Medicare Shared Savings Program Performance Year Results (data.cms.gov via mimilabs)
Key Architecture Decisions
dbMotion as HIE Core
Selected dbMotion for its proven clinical data aggregation and normalization capabilities. The platform could harmonize data from 50+ disparate EHR systems into a unified longitudinal patient record.
Outcome: Enabled real-time visibility across the entire care continuum for 40,000+ patients.
Mirth Connect Integration Interfaces
Built reusable integration interfaces inside the Mirth Connect engine for its HL7v2/FHIR transformation capabilities. Created a repeatable pattern for each EHR—custom channels for ADT feeds, lab results, and clinical documents that could be rapidly deployed to new practices.
Outcome: Enabled real-time care coordination across 9 states.
EHR Agent Extension Strategy
Extended existing EHR agents with our Provider nSights and Patient nSights capabilities, putting community, clinical, and claims data directly at the provider's desktop alongside VBC measures and financial performance. Rather than asking clinicians to use another portal, we brought insights to where they already worked.
Outcome: Drove 85%+ provider adoption by eliminating workflow disruption.
Real-Time ADT Alerting
Implemented real-time alerting system for care transitions. When a patient was admitted or discharged, their care team received notifications to enable coordination.
Outcome: Enabled proactive intervention and care coordination.
Products We Built
Patient nSights
Comprehensive patient-facing risk stratification and care gap identification. Aggregated claims, clinical, and social determinants data to surface high-risk patients before they became high-cost.
- HCC risk score optimization
- Care gap identification
- Social determinants integration
- Predictive risk modeling
Provider nSights
Unified provider desktop bringing community, clinical, and claims data together with VBC measures and financial performance. Gave physicians complete visibility into patient context, quality metrics, and cost performance at the point of care.
- Community, clinical & claims data integration
- VBC measures & financial performance
- Quality measure tracking
- Care coordination tools
HIE Community Record
Longitudinal patient record aggregating community-wide data from all participating providers. Combined clinical encounters, claims history, and care transitions into a unified view that eliminated information silos.
- Multi-EHR data aggregation
- CMS CCLF claims integration
- Medication reconciliation
- Transition of care alerts
Technology Stack
dbMotion
HIE Platform
Mirth Connect
Integration Engine
HL7v2/FHIR
Standards
SQL Server
Data Store
EHR Agent Extensions
Provider Desktop
ADT Feeds
Real-time Data
CMS CCLF / Claims
ACO Analytics
Tier III Data Center
Infrastructure
Key Lessons
Build the Team First
The best technology comes from empowered teams. Investing in people paid dividends for a decade—and continues to impact healthcare through their careers at other organizations.
Meet Providers Where They Are
Extending existing EHR agents with our nSights capabilities succeeded because we didn't ask providers to change their workflow. We put community, clinical, claims data, and VBC measures directly at their desktop.
Real-Time Data Changes Behavior
When care teams knew about hospital admits within minutes instead of days, they could actually intervene. Speed of data equals quality of care.
Consistency Beats Perfection
Ten consecutive years of positive performance came from steady improvement, not dramatic changes. Build systems that compound.
Building the Next Generation
The lessons from OnePartner—team building, provider-centric design, real-time data—now power Phiniti's Ambient Scribe. Same philosophy: reduce friction, meet providers where they are, and let technology handle the administrative burden.