Strategic Implications of Health Equity in ACO REACH, Part One

Understanding the Model’s Health Equity Components

By Rick Goddard, VP Strategy, Lumeris & Aneesh Chopra, President, CareJourney

July 11, 2022

This is part one of a two-part series discussing health equity as it relates to the ACO REACH program.

The Center for Medicare & Medicaid Innovation (CMMI) Direct Contracting Program transitions to the ACO REACH Model in PY2023. In preparation for the new model, many healthcare stakeholders have asked: what has changed?

One noteworthy change: in accordance with a key initiative of the CMMI Strategic Plan announced last year, health equity is a central component of the ACO REACH model.

In a previous blog, we provided a detailed analysis of the new model and how ACO REACH compares to Direct Contracting.

To bring a better sense of understanding to the health equity components of the new model, CareJourney and Lumeris have partnered to create a two-part blog series. In part one, we’ll help current Direct Contracting Entities who are transitioning to ACO REACH, and ACO REACH applicants planning to participate in 2023 with understanding four main components of the model:

  • Embed Health Equity into Benchmark: The Health Equity Benchmark Adjustment
  • Address Health Equity in Risk Adjustment: The Consideration of the Demographic Relative Factors Component of Risk Scores (we also analyzed the changes to risk scoring in a previous blog.)
  • Improve Data Collection: Collecting patient reported demographic and social determinants of health data to better understand beneficiaries and communities with more accurate data.
  • Ensure Accountability of Addressing Health Inequities: Form and abide by Health Equity Improvement Plans

Part one will help prospective REACH ACOs understand these four main components, while Part Two will help these organizations plan and take action to address the needs of disadvantaged or underserved populations.

To read the full blog, visit Lumeris’ website.

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