Table of Contents
Introduction
The ACO REACH program (Accountable Care Organization Realizing Equity, Access, and Community Health) has demonstrated remarkable success in transforming healthcare delivery in 2023. With net savings of $694.6 million, the program underscores its potential to advance value-based care by prioritizing equity, access, and community health. Designed to address healthcare disparities and promote better patient outcomes, ACO REACH emphasizes the importance of collaboration among providers to deliver cost-effective and high-quality care. These achievements have strengthened its reputation as a vital model for driving sustainable healthcare innovation.
The program’s success has not gone unnoticed, with the National Association of ACOs (NAACOS) championing its continuation. NAACOS has urged policymakers to extend the program beyond its current end date in 2026, citing its ability to improve health equity while generating substantial financial savings.
Understanding the ACO REACH Program
ACO REACH is a value-based care initiative introduced by the Centers for Medicare & Medicaid Services (CMS). It aims to reduce healthcare costs while improving quality by incentivizing providers to focus on holistic patient care. The program empowers participating organizations to manage costs effectively while providing high-quality services to Medicare beneficiaries.
2023 Savings Achievements
Gross and Net Savings
In 2023, the ACO REACH program reported $1.64 billion in gross savings and $694.6 million in net savings. Compared to benchmarks, participants achieved $984.4 million in net savings, showcasing the program’s capacity to generate substantial financial benefits for CMS.
Savings Distribution
Nearly three-quarters of all ACOs in the program achieved positive savings, with long-standing ACOs contributing significantly:
Established ACOs(since 2021): Generated 64% of total savings, amounting to $575.7 million.
New Entrant ACOs (2023): Contributed $108.5 million to overall savings.
These savings highlight the program’s scalability and its appeal to both veteran and new participants.
NAACOS’ Call for Extension
NAACOS’ Advocacy
NAACOS has championed the extension of the ACO REACH program, citing its consistent success in reducing costs and improving care quality. According to Aisha Pittman, NAACOS’ Senior Vice President of Government Affairs, the program’s growing clinician participation—expected to surpass 173,000 in 2024—is a testament to its effectiveness.
Benefits Highlighted by NAACOS
NAACOS emphasized the unique benefits provided by ACO REACH, including:
Cost-Sharing Waivers: Reducing out-of-pocket expenses for patients.
Chronic Disease Management Awards: Incentivizing providers to deliver comprehensive care for chronic conditions.
Quality Improvement: Reinforcing value-based care practices that prioritize patient outcomes over volume-driven services.
Performance Metrics of ACO REACH
High-Needs and New Entrant ACOs
High-needs and new entrant ACOs outperformed standard ACOs due to benchmarking policies and their smaller participation numbers. These groups achieved higher average quality scores, reflecting their focused efforts on addressing complex healthcare needs.
Quality Score Insights
The program’s average quality score was notably higher among high-needs ACOs. This underscores the program’s ability to drive better outcomes for patients with advanced or chronic healthcare requirements.
Future Directions for the ACO REACH Model
The success of the ACO REACH program underscores the need for its continuation and refinement. NAACOS has urged CMS to:
1. Extend the Program Beyond 2026: Leverage the model’s proven benefits to sustain long-term cost savings and quality improvements.
2. Develop New Cost-of-Care Models: Introduce innovative frameworks to expand the reach and impact of value-based care.
3. Enhance Clinician Participation: Encourage more providers to adopt the program by offering additional incentives and support.
These steps align with federal goals to transition all Medicare enrollees to value-based arrangements by 2030.
Conclusion
The success of the ACO REACH program in 2023, with net savings of $694.6 million, underscores its transformative potential in healthcare delivery. By advancing equity, improving access, and fostering better health outcomes for diverse communities, the program has proven itself a vital model for value-based care. Its innovative approach to addressing healthcare disparities while simultaneously reducing costs highlights the critical role it plays in the evolving healthcare landscape.
The National Association of ACOs (NAACOS) has recognized the program’s impact and is advocating for its extension beyond 2026. They emphasize that continuing ACO REACH will not only sustain its financial benefits but also expand its influence in promoting health equity and improving patient outcomes. As the healthcare system continues to shift toward more sustainable and inclusive models, ACO REACH stands out as a beacon of progress. Extending its timeline would ensure its positive contributions endure, helping to create a more equitable and cost-effective healthcare system for the future.
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FAQs
Q1: How much did the ACO REACH program save in 2023?
Ans: The program reported $1.64 billion in gross savings and $694.6 million in net savings.
Q2: Why is NAACOS advocating for the program’s extension?
Ans: NAACOS highlights the program’s success in cost savings, quality improvements, and expanded clinician participation as reasons for its continuation.
Q3: When is the current program set to expire?
Ans: The ACO REACH program is scheduled to expire in 2026.
