ACO Reach Program | An Advanced Value-Based Payment Model

The healthcare landscape in the United States is ever-evolving, and the introduction of the Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health model stands out as a milestone. As cited in CMS's "A Year in Review June 2021-May 2022," the ACO REACH program is a key accomplishment in advancing strategic initiatives. 

 Overview of the CMS Year in Review

 This comprehensive report highlights the achievements and strategic focus of CMS, setting the stage for the introduction of innovative models like this.

Key Accomplishments of the ACO Reach Program

 The ACO Reach is designed to test an innovative payment approach that better supports care delivery and coordination, particularly for patients in underserved communities. It aligns with CMS's commitment to advancing health equity, the first pillar of its strategic plan.

 Pillars of the Strategic Plan

A perspective published in the New England Journal of Medicine sees the program as a departure from regressive value-based payment models. The report suggests that previous models not only failed to reduce healthcare expenditures or improve care quality but also perpetuated disparities. In contrast, it aims to be progressive, prioritizing health equity in its design and implementation.

Comparison with Previous Value-Based Payment Models

 Failures of Previous Models

 The report in the New England Journal of Medicine criticizes traditional value-based payment models for their inability to meaningfully reduce healthcare costs or enhance care quality. It highlights how these platforms unintentionally perpetuated structural racism, hindering the pursuit of health equity.

 The Shift Towards a Progressive System

 In contrast, the program explicitly identifies equity as a central goal. This marks a shift from previous platforms and offers a promising approach to advancing health equity.

 Role in Advancing Health Equity

 Health Equity Benchmark Adjustments

 One of the distinctive features is the inclusion of "health equity benchmark adjustments." This innovative approach supports ACOs caring for socioeconomically disadvantaged patients, recognizing that providers may need increased resources for marginalized communities.

 ACOs' Health Equity Plans

 The program goes beyond benchmarks, requiring ACOs to develop and implement health equity plans. These plans aim to identify disparities in patient populations, establish equity strategies, and adopt actions to reduce healthcare disparities.

 Data Collection on Social Determinants of Health

To further emphasize its commitment to health equity, CMS mandates ACOs to collect and submit data on patient-reported demographics and social determinants of health. This data-driven approach ensures a comprehensive understanding of the challenges faced by different patient groups.

Learn more about the most advanced versions of the ACO Reach Program at Persivia.