The redesigned accountable care organization (ACO) model is called the Realizing Equity, Access, and Community Health model and is scheduled to begin in 2023.
CMS said Thursday it is redesigning its accountable care organization (ACO) model away from its Global and Professional Direct Contracting (GPDC) model into one that focuses on health equity.
Slated to begin in 2023, the ACO Realizing Equity, Access, and Community Health (REACH) Model “addresses stakeholder feedback, participant experience, and Administration priorities, including CMS’ commitment to advancing health equity,” CMS said in a statement.
In addition, CMS is canceling the Geographic Direct Contracting Model, which was announced in December 2020 by the Trump administration but was paused in March 2021.
“The Biden-Harris Administration remains committed to promoting value-based care that improves the health care experience of people with Medicare, Medicaid and Marketplace coverage,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “To fulfill that commitment, CMS, through the Innovation Center, is testing new models of health care service delivery and payment to improve the quality of care that people receive, including those in underserved communities. The Innovation Center is making improvements to existing models and launching new models to increase participation in our portfolio, and CMS will be a strong collaborator to health care providers that participate in those models.”
GPDC will continue until December 31, 2022, and then will transition to the REACH model, but for the rest of the year, CMS said it will operate GPDC "with more robust and real-time monitoring of quality and costs."
The first performance year of REACH will start on January 1, 2023, and the model performance period will run through 2026.
Earlier this month, the National Association of ACOs (NAACOS) sent a letter to HHS asking that GPDC be overhauled instead of canceled. The letter, signed by more than 200 organizations, said that ending GPDC would stall the movement to value-based care.
In a statement released Thursday, NAACOS praised CMS and said REACH was basically a continuation of GPDC, "albeit with numerous changes and a new name."
"Many of the criticisms against Direct Contracting were a product of great misunderstanding about the model and the overall shift to value-based payment," NAACOS said. "Instead, keeping the model with additional focus on equity, increased provider governance, improvements to risk adjustment, and other changes is best moving forward." CMS adopted many of the changes the organization has been lobbying for, NAACOS said.
Humana Report Shows Benefits of Value-Based Care for Patients, Physicians
December 6th 2023Patients seen at value-based care clinics received more preventive screenings and had lower risks of hospitalization and emergency room visits, according to Humana’s 10th annual value-based care report.
Read More
Study: SGLT2is Should Be Continued Despite Initial eGFR Decline in Patients With HFmrEF/HFpEF
December 6th 2023Despite an initial drop in estimated glomerular filtration rate (eGFR) after 1 month of dapagliflozin, researchers say this is not associated with subsequent risk of cardiovascular or kidney events for patients with heart failure with mildly reduced ejection fraction (HFmrEF) or preserved ejection fraction (HFpEF).
Read More
Oncology Onward: A Conversation With Thyme Care CEO and Cofounder Robin Shah
October 2nd 2023Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.
Listen
Data analysis showed that 40% of patients who filled a prescription for Wegovy in 2021 or 2022 were still taking it a year later; both Democrats and reproductive rights organizations are pressuring the Biden administration to ensure health insurers fully cover contraception; CMS implemented Medicare changes in March that limited access to blood tests that help transplant recipients ensure their organs remain healthy.
Read More
Exclusive Telemedicine Use Linked to Less Favorable Glycemic Outcomes for T2D Endocrinology Care
December 6th 2023Adults with type 2 diabetes (T2D) undergoing endocrinology care are more likely to experience less favorable hemoglobin A1c improvements if they only use telemedicine compared with patients using in-person care or a mix of both.
Read More