CMS Sets New Precedent with ACO REACH Model and Prioritizes Social Determinants of Health and Health Equity

The Centers for Medicare & Medicaid (CMS) made a pivotal announcement: In January 2023, the current Accountable Care Organization (ACO) contracting model will be replaced by a new, person-centric model with an emphasis on SDoH and a goal of achieving health equity in communities.

The Realizing Equity, Access, and Community Health (REACH) model will enable ACOs to better meet the needs of historically underserved communities, and reduce health disparities across the country.

This policy shift highlights the fact that addressing people’s social needs—and not only clinical ones—will drive down healthcare costs and lead to better health outcomes.

“Under the ACO REACH model, healthcare providers can receive more predictable revenue, and use those dollars more flexibly to meet their patients’ needs—and to be more resilient in the face of health challenges like the current public health pandemic. The bottom line is that ACOs can improve healthcare quality and make people healthier, which can also lead to lower total costs of care,” said Liz Fowler, CMS Deputy Administrator and Director of the CMS Innovation Center (CMS, 2022).

To participate, ACOs must meet the following five requirements:

1. Establishment of a transparent health equity plan 
2. Health equity benchmark adjustment
3. Health equity data collection
4. Health equity questions on application and scoring for health equity experience
5. Nurse practitioner services benefit enhancement

How Can Unite Us Help?  

Unite Us is uniquely poised to support ACOs next year. Our robust, end-to-end solution will make it easy and seamless for them to meet the new health equity requirements at every step of the care journey, from identifying social risk to engaging hard-to-reach populations, coordinating care, and measuring and improving outcomes.

With Unite Us, ACOs can:

Identify and engage underserved communities:

Our data and predictive capabilities provide unique visibility of SDoH to help proactively identify populations at risk, as well as engagement preferences and ROI predictions to inform outreach and engagement initiatives.

Build lasting community partnerships: 

We hire locally from the communities we serve, and our community engagement teams develop strong relationships and accountable, secure networks.

Improve the quality and efficiency of patients’ experiences:

With Unite Us, providers experience improved efficiency, workflows, and patient experiences. Our no-wrong-door approach means people only have to tell their story once, reducing their trauma and connecting them to the care they need, when they need it, where they are.

Measure and reduce health disparities:

With Unite Us’ outcome-focused solution, ACOs access real-time, intuitive metrics to monitor people’s needs and service impact. In turn, they can adjust resources to reduce disparities and further improve people’s health.

Since 2013, Unite Us has understood that care starts in communities, and when people’s basic social needs are met, they’re likely to be healthier. We are encouraged that this new ACO model demonstrates CMS’ commitment to direct resources and improved SDoH, which will drive better health outcomes. We support policy changes that move the needle toward health equity for all.

If you’re an ACO, find out how we can help you make this transition and support your work, so we can build healthier communities together. To learn more about our end-to-end solution for social care, visit our solutions page.