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Strategic Implications of Health Equity in ACO REACH: Part 1 of 2

July 11, 2022Rick Goddard, Aneesh ChopraLumerisSocial Determinants of Health (SDOH),ACO REACH

PART 1: Understanding the programmatic health equity components 

As the CMMI (Center for Medicare & Medicaid Innovation) Direct Contracting Program transitions to the ACO REACH Model in PY2023, many in the market have asked: “what has changed?” One notable change is the inclusion of one of the core tenants of the CMMI Strategic Plan announced last year to have Health Equity as a central component of all future CMMI models.  

In Part One* of this two-part series, Lumeris and CareJourney have partnered to help current Direct Contracting Entities prepare for their transition to ACO REACH, as well as ACO REACH applicants planning to participate in 2023 gain a better understanding of the key Health Equity components in the ACO REACH Model.  These four components are summarized as: 

  • Embed Health Equity into Benchmark: The Health Equity Benchmark Adjustment 
  • Address Health Equity in Risk Adjustment: The Consideration of the Demographic Relative Factors Component of Risk Scores  
  • Improve Data Collection across Communities: Collecting patient reported demographic and social determinants of health data to better understand beneficiaries and communities with more accurate data. 
  • Ensure Accountability of Addressing Health Inequities: Develop and abide by Health Equity Improvement Plans 

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