HIGHLIGHTS
- The Centers for Medicare & Medicaid Services (CMS) seeks to transition to value-based care payment models.
- ACO REACH addresses access to value-based care for underserved communities and improvements in care quality.
- An Abt-supported evaluation found payment reductions and quality improvements.
PROJECT
Evaluation of the Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health (REACH) Model
The Challenge
As part of a team with NORC, Abt is conducting a mixed methods evaluation of the CMS’ ACO REACH Model. Launched by CMS’s Center for Medicare and Medicaid Innovation (CMMI), ACO REACH revamps the Global Professional Direct Contracting Model. ACO REACH seeks to improve the quality of care and health outcomes for Medicare fee-for-service (FFS) beneficiaries through financial incentives that promote effective and appropriate care, with an emphasis on care delivery for complex conditions in chronically and seriously ill populations. CMS needed an evaluation team to assess model impacts and the extent to which they achieve the model’s goals.
The Approach
Abt helped design and implement the evaluation for the subset of REACH ACOs that serve Medicare FFS beneficiaries with complex medical needs (“high needs” beneficiaries). The team conducted a difference-in-differences evaluation to assess the impact of the model on healthcare use, costs, and quality for ACOs serving those beneficiaries. The team is employing a mixed-methods framework and in future reports will integrate quantitative findings with qualitative insights gained directly from the organizations, clinicians, and beneficiaries. Abt interviewed 26 model-affiliated beneficiaries to gain a baseline understanding of their perceptions of the health care system.
The Results
The high needs ACOs that Abt evaluated reduced total spending by 3.5%; at the same there were improvements in some quality metrics such as reductions in all-cause acute hospital readmissions. From the interviews Abt conducted, we heard interviewees positively describe their care teams, care planning processes, and the communication and follow-up they received from their care teams.
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