At Thanacare, we are supporting organizations advance care planning initiatives amid the industry transition from fee-for-service to value-based care. The deployment of a modern advance care planning platform, integrated and scaled, is possible because of Thanacare's focused risk-based ACP infrastructure. With a strong patient outreach system, reaching those at home and unhoused, and multiple patient access points, Thanacare supports its partners efforts to help patients avoid unnecessary ED and hospital visits. But when a visit is necessary, and especially when it is urgent, is when Thanacare strives to deliver and shares the right ACP directives at the right time to the right people. Together, we can work to ensure the patient receives the right care at the right time while moving through the care process as smoothly as possible, all while delivering a cultural competent channel. Successful VBC organizations understand that traditional and bolted EMRs don’t capture the true cost of care, nor does it allow analysis of costs across other care settings. EMRs are an important single source of truth that can support providing a better advance care planning experience for patients and providers, from introduction to documentation to usage.