On February 24th, the Center for Medicare and Medicaid Innovation (CMMI) announced the redesign of the Direct Contracting program under the new title of “ACO Realizing Equity, Access, and Community Health” (ACO REACH). CMMI also released an accompanying Request for Applications (RFA) for new applicants to participate in ACO REACH starting in 2023. At that time, the 99 currently operating Direct Contracting Entities (DCEs) must convert into REACH ACOs or leave the program.
Although the design of ACO REACH is fundamentally similar to that of GPDC, notable new elements include:
- New requirements on governance and organizational history, meant to ensure that REACH ACOs are provider-led and their ownership is aligned with CMMI’s vision;
- Modifications to the financial parameters of the model, which will increase the funds available to REACH ACOs but further limit potential increases in population risk scores;
- New health equity initiatives, including a benchmark adjustment for ACOs who have more high-need individuals attributed and a requirement to develop a Health Equity Plan and collect social needs data; and
- Additional plans by CMMI to monitor REACH ACOs to ensure compliance.
Attached are two documents, which are:
- SPG’s brief summary of changes in the ACO REACH model (available here)
- SPG’s full summary of the model (available here).
The full RFA is available here.