Lexology January 30, 2023
Ropes & Gray LLP

In December of 2022, CMS released the 2023 Accountable Care Organization Realizing Equity, Access and Community Health (“ACO REACH”) Participation Agreement (the “2023 Agreement.”) The summary below highlights key differences in the Agreement compared to its predecessor, the 2022 Global and Professional Direct Contracting Model (“GPDC Model”) Agreement (the “2022 Agreement”).

I. Overview

The 2023 Agreement imposes certain new requirements that operationalize the transition from the GPDC Model to the ACO REACH Model, including more detailed governance requirements and an explicit focus on health equity. In addition, CMS has made changes to the ACO REACH financial methodology (e.g., changes to the risk adjustment process) and has expanded its enforcement powers, particularly as it relates to the Beneficiary alignment process. Capitalized...

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Topics: ACO (Accountable Care), CMS, Equity/SDOH, Govt Agencies, Health System / Hospital, Healthcare System, Insurance, Medicare, Payment Models, Physician, Primary care, Provider, Value Based
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