Statement on CMS Redesign of the Medicare Direct Contracting Model

By Blair Childs, Senior Vice President, Public Affairs

Premier applauds the Centers for Medicare & Medicaid Services (CMS) for releasing applications for the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model. The redesigned model improves upon the earlier iteration of Medicare Direct Contracting by ensuring that healthcare providers are in the driver’s seat. ACO REACH includes several updates for which Premier has long advocated including reducing discounts to ensure providers have adequate payment under the Global track, reducing the quality withhold, and applying consistent methodologies and polices across participants to ensure healthcare providers have the same opportunity to participate as non-providers.

Premier is encouraged that for the first time, CMS has built into the payment methodology a mechanism to address equity by applying a beneficiary-level adjustment that will increase the benchmark for those ACOs serving higher proportions of underserved beneficiaries.