Accelerating the Move to Value-based Care with Data

Introduction

In January 2023, the Centers for Medicare & Medicaid Services (CMS) announced its goal to have 100% of traditional Medicare beneficiaries in an accountable care relationship with their healthcare providers by 2030. CMS plans to get there by expanding support for and participation in three accountable care initiatives:

• The Medicare Shared Savings Program (MSSP) is the largest accountable care initiative in the country, a permanent Medicare program established by the Affordable Care Act. In 2023, MSSP has 456 accountable care organizations (ACOs) and 10.9 million assigned beneficiaries
• The Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model focuses on improving care in underserved communities and in the home. In 2023 the ACO REACH model has 132 ACOs with 131,772 providers serving about 2.1 million beneficiaries.
• The Kidney Care Choices (KCC) Model addresses Medicare beneficiaries with late-stage chronic kidney disease and end-stage renal disease. For 2023, the KCC model includes 130 entities, nearly 8,400 providers and 250,000 beneficiaries.

The end goal is the familiar mantra: higher quality care at lower cost, with better coordination of care. Collectively, more than 13.2 million people and 700,000 healthcare providers and organizations are expected to participate in these Medicare models in 2023.

This guide will help you:

Provide insight on how ACOs can leverage the right data and analytics to:

• Make the accountable care model truly attractive and accessible
• Further partner with practices that care for the underserved,
• Decide which alternative payment model(s) to join in order to succeed