January 17, 2023
Preliminary CMS data shows Direct Contracting model saved taxpayer money and provided better quality care in Medicare program in 2022
Washington, DC – America’s Physician Groups (APG) congratulates its members who are among the 132 organizations participating in 2023 in the Centers for Medicare & Medicaid (CMS) Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model. APG also salutes ongoing savings from the model for the nation’s taxpayers, along with better quality outcomes relative to the rest of the Medicare program. Preliminary CMS data, for example, show that average Medicare spending was two percent below the benchmarks set for the Direct Contracting model (now ACO REACH) in the first nine months of 2022.
The APG member organizations participating in the ACO REACH Model for 2023 include physician practices affiliated with agilon health; ApolloMed; Arizona Health Advantage, Inc.; Bloom Healthcare; CareAllies; Castell, an Intermountain Company; CHESS; Collaborative Health Systems; Commonwealth Primary Care ACO; Empassion Health, Inc.; Equality Health Network; Heritage Provider Network/Regal Medical Group; Honest Medical Group; NeueHealth; North East Medical Services; Oak Street Health; OneMedical/Iora Health; Physicians of Southwest Washington; Triad Healthcare Network; Reliant Medical Group; UpStream Healthcare; VillageMD; and Wellvana Health.
“We’re proud that so many of our members are moving forward in the ACO REACH model,” said Susan Dentzer, APG President and Chief Executive Officer. “The 2023 performance year will be key for this model, as participants for the first time are held accountable for pursuing health-equity plans to reduce care disparities across racial, ethnic, and other lines.
“We also note that, to date, all model participants have achieved 100 percent compliance with quality metrics, and continue to show quality improvements relative to the rest of Medicare,” Dentzer continued. “New CMS data show that, for the 12-month period that ended June 2022, model participants achieved rates of unplanned admissions for patients with multiple chronic conditions that were lower on a statistically significant basis than across all the rest of Medicare – the traditional fee-for-service program, the Medicare Shared Savings Program, and the Next Generation ACO program as well. This result means that thousands of patients involved in what’s now the ACO REACH model have been spared unnecessary, costly, and debilitating hospital stays for chronic conditions that can be managed well on an outpatient basis, but that in much of the Medicare program often are not.”
In early 2022, the Global and Professional Direct Contracting Model was revised and renamed the ACO REACH Model, and is the first accountable care model in Medicare to directly address issues related to health equity and access. ACO REACH participants will be held financially accountable for the total health and cost of care for the fee-for-service Medicare patients who are attributed to them either through claims or voluntary alignment. The model provides for a holistic, accountable approach to treating Medicare beneficiaries, improving care for those with chronic conditions, addressing their social needs related to health and health care, and achieving greater health equity in the process.
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About America’s Physician Groups
America’s Physician Groups is a national association representing approximately 360 physician groups with approximately 170,000 physicians providing care to nearly 90 million patients. APG’s motto, ‘Taking Responsibility for America’s Health,’ represents our members’ commitment to clinically integrated, coordinated, value-based healthcare in which physician groups are accountable for the costs and quality of patient care. Visit us at www.apg.org.
Contact: Greg Phillips, APG Director of Communications, 202-770-1901, gphillips@apg.org
