News: CMS announces changes to 2024 ACO REACH model based on stakeholder feedback

CDI Strategies - Volume 17, Issue 34

In a recent news release, CMS announced changes to the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model for the performance year (PY) 2024. The value-based model began on January 1, 2023, and encourages providers to form an ACO and move away from fee-for-service in Medicare. It currently has 132 participants, HealthLeaders reported.

Among the changes, CMS reduced the beneficiary alignment minimum for different types of ACOs and will provide a 10% buffer starting in PY 2024. Eligibility criteria for alignment to a High Needs Population ACO is changing so that more beneficiaries are included, and the risk adjustment methodology in Medicare Advantage will be revised so that PY 2024 risk scores are blended with 2020 standards and the new 2024 model.

These changes are meant to improve the model test by:

  1. Increasing predictability for model participants
  2. Protecting against inappropriate risk score growth and maintaining consistency across CMS programs and Center for Medicare and Medicaid Innovation models
  3. Further advancing health equity

“We believe these changes will satisfy many concerns and stabilize future participation,” Clif Gaus, president and CEO of the National Association of ACOs (NAACOS), said in a statement. “Additionally, we encourage CMS to explore adding features of REACH into a permanent track within the Medicare Shared Savings Program (MSSP). Using MSSP as a chassis for innovation while infusing lessons learned from Innovation Center models into a permanent program is another path for stabilizing and growing participation in ACOs.”

Editor’s note: To read HealthLeaders’ coverage of this story, click here. To read CMS’ announcement, click here.

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