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On February 24, 2022, the CMS Innovation Center released the details on a new payment model, ACO REACH. ACO REACH represents a series of changes made to Global and Professional Direct Contracting (“Direct Contracting”, GPDC) to respond to criticisms faced by the program. ACO REACH adds in exciting new components aimed at closing health equity gaps in keeping with the Innovation Center’s Ten Year Plan released late in 2021.
While ACO REACH and Direct Contracting share most of the same model components, there are some important differences. At a high level, ACO REACH addressed concerns about having funded entities in control of seniors’ healthcare by requiring 75% of the ACO’s governing body be controlled by participating providers – an increase from Direct Contracting’s 25% requirement. Additionally, ACO REACH makes it easier for smaller, less-funded groups to enter the model by decreasing the discount on the benchmark from a max of 5% to a max of 3.5% by the end of the model performance.