CMS ACO Reach Model: Your Fast Track to Better Patient Outcomes (& Revenue)

CMS ACO Reach Model is designed to empower Accountable Care Organizations (ACOs) to deliver better patient outcomes while offering a path to increased revenue. The ACO Reach stands for Realizing Equity, Access, and Community Health. It’s a value-based payment program that encourages collaboration among healthcare providers within ACOs. These ACOs take on responsibility for the overall care of their assigned Medicare beneficiary population. 

Key Features of the ACO Reach Model

• Focus on Health Equity: A core principle is addressing healthcare disparities. Participating organizations must develop a robust health equity plan to identify and address the needs of underserved communities within their patient population.
• Risk and Reward Sharing: ACOs in the Reach Model share in the financial risk and reward associated with the cost of care for their assigned beneficiaries. If the ACO delivers high-quality care that keeps costs in check, they share in the savings generated. Conversely, if costs exceed benchmarks, the ACO may be responsible for a portion of those additional expenses. This incentivizes ACOs to be efficient and prioritize preventative care.
• New Tools and Resources: CMS equips Reach ACOs with valuable tools and resources to improve care coordination and population health management. This includes access to data analytics to identify high-risk patients and better target interventions.

Benefits of Participating

• Improved Patient Outcomes: By working collaboratively and focusing on preventative care, ACOs can deliver better health results for their patients. This translates to a healthier population and potentially lower healthcare utilization in the long run.
• Enhanced Revenue Opportunities: Through efficient care management and cost savings, ACOs can share in the financial rewards generated by the program. This presents a significant opportunity to increase revenue streams.
• Greater Care Coordination: The ACO model fosters better communication and collaboration among providers, leading to a more coordinated and seamless care experience for patients.
• Focus on Underserved Communities: The emphasis on health equity within ACO Reach allows providers to address the specific needs of underserved populations and create a more equitable healthcare system.

Is ACO Reach Right for You?

The CMS ACO Reach Model offers a promising path for healthcare providers who are committed to delivering high-quality, cost-effective care to their patients.  If your organization is looking to improve population health outcomes, enhance care coordination, and potentially increase revenue, then it may be a strategic fit. 

Carefully review the program details and eligibility requirements here at Persivia to determine if participation aligns with your organization's goals and resources.