Policy & Medicine September 8, 2024
The United States Centers for Medicare and Medicaid Services (CMS) recently issued changes to the ACO REACH Model, including adjusting the financial methodology and strengthening the operational flexibility and risk management. Some of the announced changes are below.
Benchmarks
One such change relates to the benchmark blend of historical/regional expenditures for standard ACOs. In performance year 2025, CMS will not increase the percentage of expenditures comprising the benchmark blend rate as previously planned. Instead, the rate for Standard ACOs will be held at a blend of 55% historical baseline expenditures and 45% regional expenditures.
Additionally, in ACO REACH, the current upward and downward adjustments from blending regional expenditures into the benchmark are limited, with the ceiling limited to 5%...
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