decisionhealth Newsletters, Part B News - 2022 Issue 3 (March)
Direct Contracting model, now ACO REACH, gets caps, governance tweaked
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Article Overview
This article explains how CMS rebranded and revised its Direct Contracting demonstration into the ACO REACH model. It focuses on the program’s updated governance expectations, health equity-related requirements, payment and risk adjustments, and participation timing. The piece is relevant to organizations and professionals following Medicare value-based care models and CMS policy changes.
Why This Topic Matters
The CMS changes described here affect how participating organizations are structured, monitored, and paid under a major Medicare value-based care model. Readers tracking ACO policy, governance requirements, and risk methodology will want to know what changed and when existing participants must decide whether to continue.
Article Sections
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Value-based care
Introduces the CMS model redesign and frames the article within Medicare value-based care policy. Summarizes the program renaming and the broad areas of change discussed in the article.
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Program redesign and major changes
Describes the new model name, the shift in participant terminology, and the main governance, equity, payment, and risk-related adjustments announced by CMS.
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Resource
Provides a source reference to the CMS fact sheet supporting the article's discussion of the model update.
What You Will Learn
- How CMS restructured a Medicare value-based care model
- What broad governance changes were announced for participating organizations
- What kinds of health equity and data collection expectations were added
- How CMS described adjustments to payment, quality withholding, and risk-related methodology
- What the transition timeline means for current participants
Who Should Read This
- Medical coders
- Revenue cycle professionals
- Practice administrators
- ACO and value-based care participants
- Health policy readers
- Compliance professionals
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