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Accountable Care Organizations (ACOs) know they need to follow regulations. That means adhering to Centers for Medicare & Medicaid Services (CMS) requirements for REACH ACOs to develop and maintain comprehensive health equity plans. For 2023, REACH ACOs are not being penalized for their health equity plan if it does not work in practice and only works on paper. However, next year REACH ACOs will have to show success, and by kicking the can down the road they risk not knowing enough about their patient population in terms of what works better and what doesn’t. With the first year of such requirements already halfway underfoot, some ACOs many already feel the pain of actually complying with the requirement in practice.
A study recently published in JAMA Internal Medicine quantified a component of that pain point in dollars, estimating it costs $60 per member each month to provide evidence-based support for housing, transportation food, and care coordination. However, federal funding only covers half of the average cost of such solutions, leaving the burden on risk-bearing organizations.