ACO REACH: Analyzing the Latest Value-Based Care Model from CMS


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By Rich Levin and Team Innovaccer. Discovered by Player FM and our community — copyright is owned by the publisher, not Player FM, and audio is streamed directly from their servers. Hit the Subscribe button to track updates in Player FM, or paste the feed URL into other podcast apps.

The CMS's Center for Medicare and Medicaid Innovation (CMMI) recently announced the strategic redesign of their current Global and Professional Direct Contracting (GPDC) model.

Beginning in January 2023, the redesigned program, known as ACO REACH, seeks to drive greater provider participation and improved quality of care, with a strong focus on improving health equity and closing the gaps for millions of vulnerable beneficiaries.

For today's show, we've assembled an expert panel to weigh in on the new ACO REACH model, including its framework, benefits, and opportunities.

On the panel: Melanie Matthews, CEO of PSW and Northwest Momentum Health Partners ACO, and President of MultiCare Connected Care. She has more than 20 years in cost-of-care management, CMMI value-based care models, and is a leading voice of physician health policies.

Joining Melanie on the panel are Brian Silverstein, MD, chief population health officer at Innovaccer; and Dan Roberts, national director for value engineering at Innovaccer.

Here’s what they discussed:

  • The design and functional framework of ACO REACH model
  • Why CMMI chose to redesign the GPDC model
  • How value in healthcare delivered through ACO REACH
  • What the different entity, risk-sharing, and payment options are for participants
  • The health equity requirements for participation under the ACO REACH model
  • What health equity data REACH ACOs need to collect
  • The advantages and disadvantages of the professional track and global track participation options
  • Why whole-person care is integral to accountability in risk-sharing arrangements
  • How the "health equity benchmark" will impact provider payments
  • How health equity data will be combined into population health analytics
  • The differences in the Medicare Shared Savings Program (MSSP) and ACO REACH
  • What is value engineering, and how does it help providers in value-based care contracts
  • How CMMI will monitor ACO REACH participants for compliance
  • Other drivers will help transition more commercial carriers from FFS to VBC

Show Resources

26 episodes