CMS Reports on Performance Improvements by ACO REACH Participants
In 2023, the 132 participants in the ACO REACH model generated $1.6 billion in gross savings and $695 million in net savings after accounting for shared savings and losses, according to the Centers for Medicare & Medicaid Services.
NAACOS, the National Association of Accountable Care Organizations, congratulated the ACO REACH participants, while urging CMS to expand and extend the program.
“Despite the lack of opportunities for new ACOS to join, the ACO REACH Model has continued to grow in the number of participating clinicians, with more than 173,000 participating in 2024,” NAACOS said in a statement. “This growth, coupled with strong performance, highlights the value in ACO REACH empowering clinicians to deliver more innovative care for traditional Medicare patients. For example, ACO REACH allows providers to offer benefits to traditional Medicare beneficiaries not otherwise allowed like cost sharing waivers, chronic disease management rewards, and more flexible care in the home.
“NAACOS urges the Centers for Medicare & Medicaid Services (CMS) to ensure that high-performing clinicians in the ACO REACH Model are provided a clear and predictable pathway forward. Given the model’s proven success, we strongly encourage CMS to extend ACO REACH beyond its current expiration date of 2026, while continuing to refine and develop new total cost of care models that will drive long-term improvements in the quality and affordability of care.”
The ACO REACH model redesigned and renamed the Global and Professional Direct Contracting (GPDC) Model effective January 1, 2023, with the goal of advancing health equity to bring the benefits of accountable care to underserved communities, promote provider leadership and governance, and protect beneficiaries and the model with more participant vetting, monitoring, and transparency.
CMS reported that among the 132 ACOs participating in the ACO REACH Model for Performance Year 2023, 96 ACOs (73%) earned net savings from financial settlement, while 36 ACOs (27%) accrued net losses. The results show that 79% of ACOs in the Global Risk option and 67% of ACOs in the Professional risk option earned shared savings.
CMS stressed that savings increases from PY 2022 are due to performance improvements by model participants as they gained experience and growth in model participation. High-Needs Population ACOs (13.3% net savings rate) and New Entrant ACOs (4.8%) achieved higher performance compared to Standard ACOs (2.8%), the result of more generous benchmarking policies as well as a smaller number of participants within the former two ACO types.
CMS cautioned that given the financial and quality results are calculated differently from the evaluation results, the latter for PY 2023 will contain different savings estimates, and typically reflect more conservative financial results. PY 2022 evaluation savings were significantly lower than savings relative to the benchmark, with $632.2 million in evaluation losses compared to $855.6 million in savings relative to the benchmark.
The PY 2023 evaluation report is expected to be released in the summer of 2025 on the ACO REACH Model webpage.
