Can ACO Reach Model Deliver on its Equity Promise?

The ACO Reach Model is a significant step by the Centers for Medicare & Medicaid Services (CMS) toward revamping healthcare delivery and prioritizing health equity. But can it truly deliver on its ambitious goals? 

Let's get into the model’s structure and its potential to address healthcare disparities.

Focus on Equity

Unlike previous accountable care models, ACO Reach explicitly prioritizes health equity. Here's how:

• Identifying Disparities: The ACO Reach Model requires participating organizations to identify health disparities within their communities. This data-driven approach ensures tailored interventions for underserved populations.
• Financial Adjustments: The model uses a risk-adjustment system that considers factors like socioeconomic status. This aims to prevent ACOs from being discouraged from serving high-needs populations due to potential financial losses.
• Beneficiary Incentives: Reach ACOs can offer incentives to patients for following care plans and attending preventive care visits. This can empower patients, particularly those who might face financial barriers to healthcare.
• Boardroom Diversity: The model mandates a governing board with at least two beneficiary advocates, including a Medicare beneficiary and a consumer advocate. This ensures patient voices are heard when making crucial healthcare decisions.

Challenges and Considerations

While the ACO model presents a promising framework, challenges remain as follows!

• Data Accuracy: Identifying and addressing disparities requires accurate data on social determinants of health. Challenges exist in collecting and utilizing such data effectively.
• ACO Formation: Establishing and managing ACOs, particularly in underserved areas, can be complex and resource-intensive. Smaller providers may struggle to participate.
• Long-Term Commitment: Transforming healthcare delivery to achieve lasting equity requires sustained effort and long-term commitment from all stakeholders.

The Road Ahead

The success of ACO Reach hinges on several factors:

• Clear Implementation Guidelines: CMS must provide clear and comprehensive guidelines for implementing the equity measures within the model.
• Supportive Infrastructure: Additional support may be needed for smaller providers to participate effectively in ACOs.
• Performance Monitoring: Regular monitoring and evaluation are crucial to assess the model's impact on health equity and make necessary adjustments.

On An Ending Note

Overall, the ACO Reach Model presents a promising path toward a more equitable healthcare system. By addressing data challenges, fostering collaboration, and ensuring long-term commitment, the model has the potential to deliver on its promise. However, close monitoring and continuous improvement will be essential for ensuring its success.

Want to get further in detail or integrate the model into your own organization? Connect with Persivia. Get a quote now!