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First Year Of ACO Realizing Equity, Access, And Community Health Program Yields Good Quality, Savings Results
Sunny C Lin1, Gmerice Hammond2, Brigette A Davis3
1Sunny C. Lin, Washington University in St. Louis, St. Louis, Missouri.
Abstract:
The Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) program is a Medicare Alternative Payment Model that launched in January 2023, based on the Global and Professional Direct Contracting Model that preceded it. The transition from that program to ACO REACH was unique in the Medicare portfolio in its focus on health equity and emphasis on capitated payments. We found that in the first year of ACO REACH, 132 participating ACOs cared for more than two million Medicare beneficiaries. Nearly nine in ten ACOs met quality cutoffs for Continuous Improvement/Sustained Exceptional Performance bonuses. The average Medicare spending benchmark was approximately $16,000 per beneficiary, and nearly three-quarters of participants had spending that was lower than their benchmark. ACOs with more experience and those with a higher proportion of medically complex beneficiaries (and thus higher benchmarks) had greater savings than newer ACOs and those with lower benchmarks.
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