The ACO Realizing Equity, Access, and Community Health (REACH) Model

Overview

CMS’ ACO REACH Model is a new program that replaces the Direct Contracting program in CMS’ drive to transform the US healthcare system and to shift, by 2030, 100% of fee-for-service care to value-based models where beneficiaries are in relationships with providers who have accountability for quality and the total cost of care.

The ACO REACH Model is an advanced alternative payment model (APM). It has been developed a successor to the Global Professional Direct Contracting (GPDC) Model based on feedback from stakeholders in earlier ACO models, including the Medicare Shared Savings Program (MSSP), the Pioneer ACO Model, and the Next Generation ACO (NGACO) Model. As such, it is custom-tailored for physicians to take their rightful positions as captains of care and to benefit financially by delivering high quality care while holding down the total cost of care.

The goals of the ACO REACH Model are:

  • Bring the benefits of affordable care to underserved communities,

  • Promote provider leadership and governance, and

  • Protect the Medicare beneficiaries and dual eligibles they serve.

One of the hallmarks of the ACO REACH Model is the high priority it places on health equity. All ACO REACH programs will develop and carry out a Health Equity Plan that identifies health disparities, defines equity health goals, establishes a health equity strategy, develops a plan to implement the strategy, and monitors progress in providing care to underserved communities.

Liz Fowler, Deputy Administrator and Director of the Center for Medicare and Medicaid Innovation, said: “Under the ACO REACH Model, health care professionals can receive more predictable revenue and use those dollars more flexibly to meet their patient’s needs—and to be more resilient in the face of health challenges like the current public health pandemic.”

As is true of any CMS program, there are many details associated with the ACO REACH Model, and some items still to be determined. To learn more about the ACO REACH Model, visit its page on the CMS website.