Make a Difference in How Healthcare is Accessed, Financed and Delivered
With Jericho REACH ACO, Physicians Can Drive and Thrive in Healthcare Payment Transformation, and Change How Healthcare is Provided
Take the Lead Position in Healthcare Transformation
At Jericho, we are working with forward thinking physicians to establish an integrated, physician-led and governed ACO REACH program in select urban and rural markets. If you want to lead change, care deeply about delivering high-quality care, and are interested in benefiting financially from efficiently delivering improved outcomes, Jericho REACH ACO is for you.
Understand the ACO REACH Model
The ACO REACH Model puts patients at the center of care and enables physicians to play the leading role in increasing the value of care delivered to Medicare beneficiaries, to better control care-related risk, and to participate meaningfully in the economic benefits generated by this new CMS payment model. The goals of the 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.
Jericho Reach ACO: A Comprehensive Model
In Jericho’s version of this new ACO REACH model, physicians are in the lead, care outcomes are improved, underserved beneficiaries are lifted up, the cost curve is bent, and physicians have multiple opportunities for new revenue streams. The vision includes:
Physicians remain independent and focus on providing care, and delegate the day-to-day administrative and operational aspects of the program to a team of dedicated business and healthcare professionals who work transparently in the physicians’ interest,
Collaborative care is coordinated across an integrated, multi-specialty network of providers and partners,
Gaining access to life- and cost-saving initiatives like Chronic Care Management as well as data sharing and analysis, and
Benefitting from a long-term vision of becoming a Provider-Sponsored Health Plan that applies the operating and financial model to other payer types.
Improve Care Quality, Generate Savings and Increase Your Earnings
In Jericho, physicians remain independent and focus on providing care. Savings are realized while care quality is maintained and improved. Physicians who participate in Jericho can expect to see a meaningful increase in their earned income for providing care to the same number of Medicare beneficiaries and dual eligibles that they provide care to today. The increase is primarily caused by two factors:
In an ACO REACH program like Jericho’s, physicians benefit from savings versus benchmark for all aspects of Medicare spending, not just Part B spending. According to CMS, today physicians receive only 7% of the total care dollars. As a result, Jericho physicians now have the potential to benefit from savings in the other 93% of care dollars. Based on detailed data analysis of historical claims data, Jericho believes that savings of 30% versus benchmark are attainable while improving the quality of care delivered and the patient experience.
Jericho expects to provide participating physicians with new care-related revenue opportunities and investment opportunities.
Some of the ways savings are achieved are by:
Shifting care to less costly, but clinically appropriate settings
Optimizing primary care, preventive care and chronic care to reduce need for acute care
Connecting all involved in patient care to enable better collaboration and coordination
Here’s an example of how savings are generated: A typical Medicare patient has COPD. A physician participating in Jericho REACH chooses the patient’s home as a clinically appropriate care setting and assigns a distributed care team for the patient because doing so is as effective as, and less costly than, caring for the patient in a hospital that is often followed by a nursing home stay.
The patient wins by receiving effective care in a preferred location (their home) while also saving $1,484 in out-of-pocket deductible.
Jericho REACH–and the physicians who participate in and own it–also win because Part A (hospital R&B) savings are realized.
Typically, the potential savings associated with a COPD case are $4,500, or 50%. Similarly, Orthopedic cases moved to ambulatory surgical settings can typically save over $6,000 per case.
In addition, ACO REACH participation automatically qualifies physicians for the Medicare Quality Payment (QPP) program where physicians can earn up to 10% of your traditional Medicare claims as a bonus based on your MACRA / MIPS score. Participation in an Advanced Payment Model (APM) ACO satisfies your Medicare MIPS requirements. For example, if Medicare calculates your MIPS bonus as 3% of your Medicare FFS schedule, a REACH ACO will pay your 7% premium instead of your MIPS bonus, increasing your revenue by 4%. If your MIPS bonus is 10%, you will be paid that amount.
Medicare determines which of your current Medicare patients will be included in the ACO based on the percentage of primary care services they have received from you as compared to those received from other providers. In addition, other patients may voluntarily choose a physicians as their provider of record.
A Care Network that Supports Physicians
A complete health system without walls including advanced practice providers, home care, chronic care, urgent care, transitional care, etc.
Senior living and care settings
Community based SDoH, PACE, FQHCs, ASCs, office-based labs, etc.
Supporting technology for clinically integrated care delivery and omni-channel beneficiary engagement
A Managed Services Organization Handles the ACO’s ‘Back Office’
Finds candidates for the program leadership team
Finds, contracts with, and manages care delivery network partners
Forms, manages and supports an Advisory Board comprised of leading physicians
Provides education and training related to practice onboarding/orientation and day-to-day interaction with network partners to realize savings, and runs a support hotline for those interactions and other matters
Provides a template governance structure for modification and adoption by participating physicians
Contracts for risk management insurance
Physician and provider support hotline
Implements and supports infrastructure-as-a-service
Take the Next Step
Get Custom Information Specific to Your Financial Opportunity With No Obligation
Physicians who contact Jericho now will learn more, get answers to their questions, and receive a no-cost, no-obligation custom financial analysis of their opportunity. CMS requires physicians to make a non-binding expression of interest by August 4, 2022, but the decision whether or not to participate in the full program starting January 1, 2023 does not need to be made until later in the year.