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

August 1, 2022Erica Everhart, Sally EngelmanLumerisACO REACH

CMS’ announcement of the redesigned Global and Professional Direct Contracting (GPDC) program, now ACO REACH, created an opportunity for REACH participants to focus on health equity and to finally receive reimbursement payments that are adjusted to their patients’ specific needs. This post is the second part of a two-part series. Now that we understand how ACO REACH benchmarks and health equity adjustments are made, let’s focus on how to “Plan” and “Act” to implement health equity plans that tackle the main drivers of health equity.  

CMMI has released preliminary guidance on the Health Equity Plan (HEP). The official PY2023 HEP will be due no later than March 31, 2023, which will be after REACH ACOs receive their PY2023 aligned beneficiary populations, to best identify and address disparities in their respective communities. CMMI has also created an opportunity to receive feedback on their proposed HEP in advance of the mandatory submission in March 2023. The optional preliminary HEP is due to CMS by September 16, 2022. More information on the preliminary submission can be found on CMS’ website.   

A multidisciplinary workgroup is a great starting point for health equity intervention planning. Based on clinical quality frameworks pioneered by the Institute for Healthcare Improvement (IHI) as well as Lean methodology, this blog post will outline a process that can be considered best practice to establish and execute a health equity initiative at your organization. 

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