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First Look at Open CMMI Model Data: Value-based Care Growth Drivers in 2022

January 25, 2023Zach Bredl, Joe Mercado, Erica EverhartCareJourneyVBC Development, Growth & Expansion,Data Aggregation, Analytics, Quality, and Validation,CMS, CMMI, Government, Policy & Regulations,Partnerships, Collaboration, Network DevelopmentCareJourney

CMS recently reaffirmed its goal to have all Medicare beneficiaries and the vast majority of Medicaid beneficiaries in a care relationship accountable for cost and quality by 2030.1 To advance model transparency and facilitate greater collaboration, CMMI released detailed model data to authorized researchers, including CareJourney (“Research Identifiable Files”).2 In the weeks ahead, we will explore a number of key priority topics but thought to publish an initial snapshot of the Global and Professional Direct Contracting model (“DCE”) through performance years 2021 and 2022 (data is current through December 31, 2022).

For context, CMS noted that the successor to the DCE model, ACO REACH accounted for a sizable share of the increase in beneficiaries in accountable care relationships, from 1.8 million in 2022 to 2.1 million in 2023.3 The Kidney Care Choices model grew faster, but on a smaller base to reach nearly 250,000 beneficiaries for 2023. While the Medicare Shared Savings Program showed a slight decrease in participation, down to 10.9 million in 2023 after serving 11 million beneficiaries in 2022, we share CMS’ optimism that recent changes to the model, including incentives to onboard clinicians practicing in underserved communities, should reverse this trend.

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