Year one of Medicare Advantage delegation presents a key challenge: frameworks exist, but operational structures must be built to make PHM functional. This session shares Cleveland Clinic’s real-world experience translating PHM frameworks into governance, workflows, workforce readiness, and data/reporting systems that meet NCQA HPA standards. Attendees will learn innovative, actionable strategies to implement risk stratification, care coordination workflows, audit-ready documentation, and dashboards that support both compliance and high-quality, person-centered care. The session highlights multi-disciplinary workforce training for care coordinators and quality staff as essential for success. Early successes, lessons learned, and ongoing course corrections are presented to provide practical takeaways that other health systems and delegated entities can replicate when implementing PHM programs under Medicare Advantage or other value-based contracts.

Key Takeaways:

• Frameworks require structures to be functional: governance, workflow, workforce, and dashboards.
• Multi-disciplinary workforce training is critical for adoption and compliance • Year-one lessons are replicable and provide a foundation for continuous improvement.
• Internal collaboration across care coordinators, quality staff, and operational leadership accelerates PHM implementation