WHAT IS ACO REACH MODEL EXPLORING ITS IMPACTS ON HEALTH EQUITY & FINANCIAL RISK

2. The Centers for Medicare and Medicaid Services (CMS) have introduced the ACO Model to redefine the landscape of healthcare management. This innovative approach holds the potential to significantly impact health equity and financial risk. Let’s take a concise look at what is ACO Reach Model & how it’s reshaping the healthcare industry. WHAT IS ACO REACH MODEL? The ACO Reach Model is all about transforming the way healthcare providers and organizations deliver care. It emphasizes collaboration and risk-sharing, intending to benefit both patients and healthcare providers. ACO REACH’S UNIQUE GOVERNANCE This Model’s governance structure is a standout feature. It mandates that participating providers make up at least 75% of the governing body of each ACO. This ensures that healthcare providers remain at the core of accountable care. With the majority of the governing body being participating providers, they have the autonomy to make decisions regarding the level of risk they’re willing to assume for their patients.

3. GAINS AND RISK-SHARING ACO Reach offers two risk-sharing options: Professional and Global. The Professional option carries a lower risk-sharing rate of 50%, making it a less risky proposition for healthcare providers. On the flip side, the Global alternative presents a higher risk-sharing rate of 100%. While it may seem daunting, it can be advantageous when accountable care is effectively implemented. With Global risk-sharing, healthcare organizations retain a larger portion of the savings they generate, as CMS receives a smaller share. This incentivizes organizations to provide exceptional care and take on higher levels of risk. ELEVATING HEALTH EQUITY ACO Model is a game-changer when it comes to addressing health disparities. All participating organizations must create a plan to identify and rectify health inequalities in their patient populations. Moreover, organizations serving the most at-risk patients are required to meet higher financial spending targets, adjusted according to their health equity benchmarks. This approach ensures that healthcare resources are allocated where they are needed most.

4. COMMITMENT TO TRANSPARENCY • CMS is committed to being transparent about the ACO Model, ensuring that progress and information are readily available. The following information will be shared: • Type of participants and their respective organization websites. • The chosen risk-sharing alternative. • Preferred payment options. • Enhanced benefits and incentives for beneficiaries under their care. LEVERAGING TECHNOLOGY FOR SUCCESS All in all, healthcare administration is evolving rapidly, and healthcare providers need to utilize innovative software solutions like the ACO Reach Model to streamline their operations. One such pioneer in the development of healthcare operational software is Persivia, which offers a reliable partnership for improved healthcare delivery.