Now accepting LEAD ACO partners · Spring 2026 RFA

The operating system that turns value-based care into repeatable performance

Nightingale is the full-stack technology platform purpose-built to launch and run a full risk ACO. Not another dashboard. Not another point solution. The proven end-to-end solution — forged inside the highest-performing REACH ACO in the country.

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15–17% Sustained savings rate

#1 Affiliate-model REACH ACO

$280M+ Book of business, zero outside capital

HPP CMS High Performers Pool

The Reality

Value-based care isn't a program. It's a system. And if you don't master the system, it will master you.

Most organizations entering value-based care dramatically underestimate the operational breadth required to succeed. Claims administration, clinical workflows, quality measure execution, financial reserving, compliance, attribution management, provider engagement — all deeply interconnected, all mission-critical, all required from day one.

Point solutions create point failures

Stitching together separate vendors for claims, analytics, quality, and compliance creates integration risk, data fragmentation, and operational gaps that compound under pressure.

Data without action is expensive noise

Organizations spend months building data infrastructure only to discover that dashboards and analytics don't drive performance — operational execution does.

DIY dramatically underestimates the work

Internal IT teams that attempt to build these systems typically discover — well into the process — they've built 30% of what they need with no path to the other 70%.

You don't know what you don't know

The domains that matter most are the ones new entrants don't realize are required — until they're already in trouble. That's the gap Nightingale was built to close.

The Platform

Not a tool. A proven operating playbook, delivered as software.

Nightingale spans every operational dimension required to launch and run a full risk ACO — from claims to clinical workflows to compliance to finance. One unified system replaces fragmented tools, manual handoffs, and one-off processes.

Full-stack operating system

Financial, clinical, and operational infrastructure designed to run full-risk care at scale. Every capability built because real operational necessity demanded it.

Living patient intelligence

Claims, hospitals, pharmacies, labs, and charts continuously reconciled into a single, reliable view of every patient — with risk-stratified alerting and precision performance signals.

Platform and playbook in one

Software infrastructure combined with the operational methodology required to launch and run value-based care. Not just what to see — what to do, and when.

Precision performance signals

Critical information surfaced at the moment action matters. 60–90 second pre-visit reviews, between-visit worklists, risk-stratified alerting — calibrated to real provider time budgets.

Provider-native design

Designed around how clinicians actually work and allocate attention. The right density of information, in the right format, at the right moment — and stays out of the way when it should.

Aligned economics

Nightingale's success is structurally tied to partner performance. When you generate savings, Nightingale participates. Incentive alignment is built into the business model.

Proven at the Top

Forged inside the highest-performing ACO in the country.

Nightingale wasn't built in a lab. Over eight years, the platform was developed and refined iteratively as the core operating system behind Florence Provider Network — which became the #1 affiliate-model REACH ACO in the country. Every capability exists because a real, high-stakes Medicare environment demanded it.

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15–17%

Sustained annual savings rate across multiple performance years

Highest-performing affiliate-model ACO in the REACH program

HPP

Qualified for CMS High Performers Pool — substantial bonus payments

8 yrs

Of iterative development under real operational pressure

Partnership Models

We meet you where you are.

From platform-only to full ACO administration, Nightingale offers a modular partnership scaled to your capabilities, ambition, and timeline. Aspects of each tier can be mixed and matched to maximize your probability of success.

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Platform

The technology operating system

+ Practice Partners

Embedded field support at 1:15–20 PCPs

+ Full Administration

ACO-in-a-box — you bring the providers

ACO LEAD

The LEAD opportunity is here. The window to apply is now.

CMS is launching the ACO LEAD Model — a 10-year program for organizations to bear financial risk for Medicare populations. LEAD is the direct successor to REACH, and Nightingale was built on REACH. We are the lowest-risk path to launch.

Cash flow from day one

LEAD ACOs receive capitation payments from Performance Year 1 — predictable, substantial operating revenue from the outset.

REACH → LEAD continuity

Essentially all operational, compliance, and financial requirements from REACH carry forward into LEAD. Nightingale's platform was built on exactly these requirements.

Proprietary underwriting

Nightingale arrives with a proactive, data-driven business case showing why the LEAD opportunity is profitable for your specific organization.

From zero to launch-ready

With Tier 3, Nightingale can take any interested party from no ACO infrastructure to a fully operational ACO LEAD — the lowest-risk path in the market.