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Social, economic, and geographic disadvantages create significant disparities in healthcare, such as lower quality of care and lesser health outcomes. To help improve these issues, the Centers for Medicare & Medicaid Services (CMS) redesigned the Global and Professional Direct Contracting Model under the new name, the Accountable Care Organization Realizing Equity, Access, and Community Health (or ACO REACH) Model. This new model will test ways to address health inequities by focusing on alternative payment structures that could better support accountable care delivery and care coordination.
What this means for the entire healthcare system isn’t yet fully known, but ACOs will find new policies to follow come January 2023. Chief among them will be to develop a health equity plan, which should detail identified health disparities and intended actions to remedy such inequities. ACOs must also apply health equity adjustments to performance benchmarks, capture demographic and social needs data, and implement beneficiary engagement incentives. When combined, the hope is to not only improve the delivery and coordination of care, but also encourage beneficiaries to change unhealthy habits and behaviors.