Patient360

What Patient360 does

Patient360 is a privately held healthcare IT company (Patient360 LLC) operating a cloud-based SaaS platform that functions as a CMS Qualified Registry and Qualified Clinical Data Registry (QCDR). Founded in 2005 and operating with 11-50 employees, the company helps physician practices, specialty provider groups, Accountable Care Organizations (ACOs), and clinically integrated networks report clinical quality measures to CMS under the Merit-based Incentive Payment System (MIPS), MVP, and APM Performance Pathway (APP+) programs. The company positions itself as one of the original 16 registries vetted by CMS and has maintained QCDR status across multiple years, including an award for 2026.

The platform is organized around three integrated reporting pathways — MIPS360 for traditional MIPS/MVP reporting, QCDR Reporting for specialty-specific proprietary measures, and ACO Registry Reporting (eCQM/CQM/MCQM) supporting APP+ — supplemented by an EHR Integration module and a client portal. Technically, the platform supports flexible data acquisition via API, sFTP, drag-and-drop, direct upload, and QRDA III import; automated collection, validation, de-duplication, aggregation, and scoring of quality measure data across multiple EHRs; a real-time MIPS score calculator; and analytics at the ACO, TIN, and NPI levels with benchmark comparisons and year-over-year tracking. A distinctive asset is its portfolio of in-house QCDR measures developed for 17+ specialties, often co-developed with partners such as East Tennessee State University, the Maine Osteopathic Association, Limber Health, and WebPT.

The business model is subscription-based, priced per provider (e.g., the M4B "MIPS for Beginners" program at $149 per provider; historical 2017 pricing of $349 for MIPS registry reporting and $449 for QCDR reporting), with ACO reporting priced on a per-member-per-month basis tied to Medicare beneficiary counts, and Promoting Interoperability available as an optional add-on. Go-to-market is a direct enterprise field sales and inside sales motion supported by content marketing (an extensive blog, resource library, webinars), SEO, testimonials/case studies, LinkedIn, and colleague referrals, feeding website demo requests and intake forms. Current pricing is quote-based and governed by individual Subscription Agreements. The company is an LLC with governing law and jurisdiction in Rhode Island and a stated Sacramento presence; no external funding, venture, or private equity investment is disclosed.

Name

Patient360

Legal name

Patient360 LLC

Website

https://patient360.com

Company type

Private

Founded year

2005

Operating status

Operating

Headcount range

11–50 employees

Short description

Patient360 is a CMS Qualified Registry and QCDR operating a cloud-based SaaS platform that helps physician practices, specialty groups, and ACOs report MIPS, MVP, and APP+ clinical quality measures to CMS to avoid penalties and optimize Medicare reimbursement.

Ownership category

akta.pro rank

Product category

Healthcare Quality Reporting Software

NAICS

Custom Computer Programming Services (541511), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518)

SIC

Services-Computer Programming, Data Processing, Etc. (7370)

akta.pro primary industry

FHIR/HL7 Data Repositories & Canonical Data Models (HLACAIAI)

akta.pro secondary industries

Real-World Data (RWD) Platforms & Clinical Data Curation (HLACAIAJ), Clinical Coding Support (ICD/CPT/SNOMED) & Documentation Compliance Tools (HLACAAAO)

Keywords

• MIPS registry reporting
• QCDR quality reporting
• ACO registry reporting
• CMS quality reporting
• Healthcare EHR integration

Headquarters

HQ city

Sacramento

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

Technology or R&D, Personnel, Operations, Marketing or Sales, Infrastructure

Revenue model

1. Subscription SaaS (MIPS Registry Reporting): Patient360 provides its cloud-based MIPS/QCDR registry reporting services on a subscription basis pursuant to a Subscription Agreement. Pricing is per provider, with programs such as M4B (MIPS for Beginners) offered at $149 per provider. The subscription model provides end-to-end MIPS reporting including data submission, scoring, and analytics.
2. Subscription SaaS (QCDR Reporting): QCDR-specific reporting subscriptions offered at $449 per provider (historical pricing noted for 2017). QCDR reporting provides access to unique specialty-specific measures beyond standard MIPS registry measures, targeting practices with limited MIPS Quality Measure options.
3. Promoting Interoperability Add-on: Optional add-on service for Promoting Interoperability submission handled on behalf of groups under a separate agreement, available as an upsell to core MIPS/ACO reporting subscriptions.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels10 records

Core offering

Patient360 is a CMS-certified Qualified Registry and QCDR vendor that operates a cloud-based SaaS platform enabling healthcare providers and accountable care organizations to collect, validate, score, and submit MIPS, MVP, and ACO quality measure data to CMS. The platform supports EHR data acquisition through API, sFTP, drag-and-drop, and direct uploads, and includes proprietary specialty-specific QCDR measures developed across 17+ medical specialties.

Product overview

Patient360 operates as a unified cloud-based SaaS platform serving as a MIPS CMS Qualified Registry, offering healthcare providers comprehensive quality reporting solutions. The platform comprises three integrated reporting pathways: MIPS360 for traditional MIPS and MVP reporting, QCDR Reporting for specialty-specific unique measures, and ACO Registry Reporting for accountable care organization requirements under APP+. A proprietary client portal enables secure data uploads, while EHR Integration services provide seamless data flow between provider systems and the Patient360 platform. The platform delivers end-to-end functionality from measure selection and data collection through CMS submission, supplemented by real-time scoring analytics and year-over-year benchmarking.

Differentiator

Problem solved

Functional benefit

Products and services

• MIPS360 A MIPS/MVP registry reporting module offering end-to-end bonus opportunities, data submission across all MIPS categories, real-time score calculation, and real-time data analysis for healthcare providers optimizing Medicare quality reporting performance.
• QCDR Reporting Qualified Clinical Data Registry reporting service providing access to unique QCDR measures unavailable elsewhere, supporting specialty-specific measure development and co-stewardship of measures for targeted provider groups across 17+ specialties.
• ACO Registry Reporting (eCQM/CQM/MCQM) Comprehensive ACO reporting platform supporting APM Performance Pathway (APP+) requirements with data aggregation across multiple EHRs, ACO/TIN/NPI-level analytics, benchmark comparisons, year-over-year tracking, and direct API submission to CMS for electronic and clinical quality measures.
• EHR Integration Data integration service connecting Patient360 with healthcare provider EHR systems, enabling automatic data flow for quality program reporting without manual uploads or cumbersome data extracts.
• M4B (MIPS for Beginners) An entry-level MIPS reporting program designed for smaller practices requiring minimal data submission (one patient encounter), offering simplified measure selection and step-by-step guidance for physicians new to MIPS reporting.

Quantifiable outcome

• Practices scoring below 75 points on MIPS face payment adjustments of up to -9% on 2027 & 2028 Medicare Part B payments. Patient360's real-time tracking and expert guidance helps practices avoid penalties and achieve maximum positive adjustments.
• +1 more outcomes

Named customers8 records

Segments5 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration1 record

AI capability4 records

Feature6 records

Partnerships

Three partnerships are on record, tiered core.

• East Tennessee State University (ETSU) — Department of Health Services Management & PolicycoreStrategic or Co-development Partner · 1 January 2026Patient360 collaborates with ETSU's Department of Health Services Management & Policy for QCDR measure development. The partnership has produced multiple QCDR measure sets including IROMS measures (IROMS11-20), Advancing Musculoskeletal (MSK) Care and Rehabilitation QCDR, and MSK and Rehabilitative Care Outcomes measures. ETSU co-stewards these measures with Patient360 for CMS approval.
• Limber HealthcoreStrategic or Co-development Partner · 1 January 2023Patient360 partnered with Limber Health alongside ETSU for the 'Patient360 in Collaboration with ETSU and Limber Health' QCDR program, providing MSK care and rehabilitation measures for submission to CMS.
• Maine Osteopathic Association (MOA)coreStrategic or Co-development Partner · 1 January 2022Patient360 partnered with the Maine Osteopathic Association (MOA) for QCDR measure development. Under this collaboration, P360 successfully created seven new measures (MOA1-MOA15) benefiting practices in osteopathy, physiatry, physical medicine & rehabilitation, pain, orthopedics, anesthesia, chiropractic, occupational/physical therapy, and podiatry. This was the program's official title: 'MOA in Collaboration with Patient360'. MOA/P360 provided real-time and regular reporting around quality and performance with more frequent reporting allowing providers to modify regimens and elevate patient outcomes.

Scale indicators3 records

Recent moves5 records

Expansion highlights5 records

Direct peers

• Healthmonix: Direct MIPSpro MIPS/QCDR registry competitor. Both are CMS-vetted Qualified Registries offering per-provider subscription pricing with QCDR measure development. Healthmonix is the closest like-for-like competitor to Patient360's MIPS360 and QCDR products.
• Medisolv: Direct competitor providing MIPS, eCQM, and quality reporting software for hospitals and physician practices. Medisolv overlaps with Patient360's MIPS registry and ACO/APP reporting value proposition, particularly for ACO-level reporting workflows.
• Mingle Analytics: Direct MIPS reporting registry competitor serving specialty practices and ACOs. Similar per-provider subscription model targeting the same QPP-eligible provider segment with QCDR-style measure offerings.
• Azara Healthcare: Direct MIPS and quality reporting competitor focused on ACOs, Federally Qualified Health Centers, and physician practices. Competes in overlapping ACO/APP reporting use cases with Patient360's ACO Registry Reporting product.
• QMSys / QualityMetrics: Smaller CMS Qualified Registry competitor offering MIPS reporting for specialty practices. Competes for the same MIPS-eligible provider segment with comparable per-provider subscription pricing and QCDR measure sets.

Emerging players

• Arcadia: Healthcare data and analytics platform serving ACOs and value-based care organizations. Overlaps with Patient360's ACO/APP segment by aggregating clinical data across EHRs for quality reporting and risk adjustment.
• Lightbeam Health Solutions: Value-based care analytics platform serving ACOs and risk-bearing provider organizations. Overlaps with Patient360's ACO Registry Reporting and APM Performance Pathway (APP+) use cases by aggregating EHR data for shared-savings optimization.
• Innovaccer: Healthcare data platform unifying EHR and claims data for value-based care. Adjacent to Patient360 in clinical data aggregation and quality reporting for ACOs, with broader scope into population health and risk adjustment.

Broad incumbents

• Premier Inc. Large healthcare improvement company including acquired registry services (formerly CECity). Operates broadly across quality measurement, supply chain, and performance services, overlapping with Patient360's MIPS/QCDR registry and ACO analytics offerings.
• Cotiviti: Healthcare analytics and payment accuracy company operating broadly across quality, risk adjustment, and value-based care. Adjacent to Patient360 in quality measurement workflows for payers and providers operating under value-based contracts.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/patient360
• Xx.com/Patient_360

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Patient360