What You Need to Know About Medicare's New ACO REACH Model - McDermott

What You Need to Know About Medicare’s New ACO REACH Model

Overview



On February 24, 2022, the Centers for Medicare & Medicaid Services (CMS) Innovation Center announced that it would be transitioning the Global and Professional Direct Contracting Model to a new model designed to incorporate the Administration’s equity priorities, Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health (REACH) in 2023.

That leaves healthcare organizations facing a daunting array of changes to governance, compliance, transparency and oversight of model participants. Applications for the new ACO REACH model are due April 22, 2022, and current Direct Contracting Entities who transition to the ACO REACH in 2023 will also be subject to the new model requirements under an amended participation agreement – so there’s no time to lose when it comes to getting your organization ready to make the switch.

The webinar will address the policy and legal considerations that organizations face in the transition from Direct Contracting to ACO REACH, including:

  • New financial model elements, including an equity adjustment for underserved populations
  • New governance requirements that emphasize the roles of providers and beneficiaries on governing boards
  • Model oversight and compliance requirements, including examining switches from traditional Medicare to Medicare Advantage
  • Increased transparency requirements and disclosures as part of the application and potential liability associated with enhanced reporting
  • Ongoing political scrutiny of the model and what it could mean for the future.

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