Addressing Health Disparities Through The CMS ACO Reach Model

The CMS ACO Reach Model is a payment and service delivery model designed to improve health equity and quality of care for Medicare beneficiaries. ACOs participating in this model receive additional payments and support to address health disparities and social determinants of health.

Here's how this CMS model is making a difference:

Strategies for Addressing Health Disparities

• Community Engagement: ACOs engage with local communities to understand their unique needs and develop targeted interventions. This engagement may include partnerships with community organizations and leaders to address social determinants of health.
• Care Coordination: They improve care coordination among healthcare providers to ensure beneficiaries receive timely and appropriate care. This includes ensuring that patients receive necessary follow-up care and referrals to specialists.
• Social Determinants of Health: ACOs address social determinants of health, such as housing, food insecurity, and transportation, which can impact health outcomes. They may provide resources and support to help beneficiaries access these services.
• Cultural Competency: Healthcare organizations promote cultural competency among healthcare providers to ensure that care is sensitive to the diverse needs of patients. This includes providing training and resources to help providers better understand and address their patient's cultural beliefs and practices.

Impact of the CMS ACO Reach Model

 

• Improved Access to Care: Beneficiaries in underserved communities have improved access to primary care, preventive services, and specialty care. This has led to better management of chronic conditions and improved overall health.
• Better Health Outcomes: The model has led to improvements in health outcomes, including reductions in hospitalizations and emergency department visits. Beneficiaries receive more appropriate and timely care, leading to better health outcomes.
• Reduced Disparities: By addressing social determinants of health and improving care coordination, the model has helped reduce disparities in health outcomes among Medicare beneficiaries. Beneficiaries in underserved communities are experiencing more equitable health outcomes compared to their peers in more affluent areas.

Future Directions

Moving forward, there are several areas for future development and expansion:

• Expansion: The CMS ACO Reach Model may be expanded to reach more beneficiaries and address health disparities in additional communities. This could incorporate expanding the model to other states and regions.
• Innovation: Healthcare organizations are encouraged to innovate and develop new strategies to address health disparities. This could include leveraging technology, such as telehealth and remote monitoring, to improve access to care for beneficiaries in underserved areas.
• Partnerships: They can continue to partner with local community organizations and leaders to address social determinants of health. By working together, ACOs and community partners can develop more effective and sustainable solutions to health disparities.

Connect with Persivia to learn more about ACO Reach.