The ACO REACH is a voluntary CMMI model scheduled to operate for 4 years from 1/1/2023 until 12/31/2026. The Request for Applications (RFA) was released on February 24, 2022, and the application opens March 7.
The Geo Direct Contracting model is scrapped, and ACO REACH is replacing GPDC.
Improve the focus on:
— Promoting health equity and addressing historical healthcare disparities for underserved communities.
— Continuing the momentum of provider-led organizations participating in risk-based models.
— Protecting beneficiaries and the model with more participant vetting, monitoring and greater transparency.
TIMELINE
● The GPDC Model originally consisted of 6 performance years (PYs): PY2021 through PY2026.
● The policy changes and new name (ACO REACH Model) will take effect at the start of PY2023 and continue through PY2026.
PARTICIPANTS
● Model participants referred to as REACH ACOs.
GOVERNANCE
● Participating providers generally must hold at least 75% of the governing board voting rights.
● Each REACH ACO governing board must include a beneficiary representative and a consumer advocate, who must hold governing board voting rights and must be different people.
HEALTH EQUITY
● Requirement for all REACH ACOs to develop a Health Equity Plan that must include identification of health disparities and specific actions intended to mitigate the health disparities identified.
● Introduction of a health equity benchmark adjustment to better support care delivery and coordination for patients in underserved communities.
● Requirement for all ACOs to collect beneficiary-reported demographic and social needs data.
● New Benefit Enhancement to increase the range of services that may be ordered by Nurse Practitioners to improve access.