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The Centers for Medicare and Medicaid Services (CMS) has announced a redesigned Accountable Care Organization (ACO) model that better reflects the agency’s vision of creating a health system that achieves equitable outcomes through high quality, affordable, person-centered care. The ACO Realizing Equity, Access, and Community Health (REACH) Model, a redesign of the Global and Professional Direct Contracting (GPDC) Model, addresses stakeholder feedback, participant experience, and Administration priorities, including CMS’ commitment to advancing health equity.
In addition to transitioning the GPDC Model to the ACO REACH Model, CMS is canceling the Geographic Direct Contracting Model (also known as the “Geo Model”), effective immediately. The Geographic Direct Contracting Model, which was announced in December 2020, was paused in March 2021 in response to stakeholder concerns. A comparison table of ACO REACH and GDCM is available for additional information.
CMS, through the Innovation Center, is testing new models of health care service delivery and payment to improve the quality of care that people receive, including those in underserved communities. The Innovation Center is making improvements to existing models and launching new models to increase participation in our portfolio, and CMS will be a strong collaborator to health care providers that participate in those models.”
As CMS works to achieve the vision outlined for the next decade of the Innovation Center, CMS wants to work with partners who share its vision and values for improving patient care, guided by three key principles. First, any model that CMS tests within Traditional Medicare must ensure that beneficiaries retain all rights that are afforded to them, including freedom of choice of all Medicare-enrolled providers and suppliers. Second, CMS must have confidence that any model it tests works to promote greater equity in the delivery of high-quality services. Third, CMS expects models to extend their reach into underserved communities to improve access to services and quality outcomes. Models that do not meet these core principles will be redesigned or will not move forward.
REACH ACOs will be responsible for helping all different types of health care providers — including primary and specialty care physicians — work together, so people get the care they need when they need it. In addition, people with Traditional Medicare who receive care through a REACH ACO may have greater access to enhanced benefits, such as telehealth visits, home care after leaving the hospital, and help with co-pays. They can expect the support of the REACH ACO to help them navigate an often complex health system.
The GPDC Model will continue until December 31, 2022, and then will transition to the ACO REACH Model. The first performance year of the redesigned ACO REACH Model will start on January 1, 2023, and the model performance period will run through 2026. CMS is releasing a Request for Applications for provider-led organizations interested in joining the ACO REACH Model. Current participants in the GPDC Model must agree to meet all the ACO REACH Model requirements by January 1, 2023, in order to participate.
The Health Resources and Services Administration (HRSA) is making more than $560 million in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 4,100 providers across the country this week. Providers will receive an email notification by Thursday, February 24 if their application was among those processed in this latest batch. HRSA is working to review all remaining applications as quickly as possible.
With today’s announcement, a total of nearly $11.5 billion in PRF Phase 4 payments has now been distributed to more than 78,000 providers in all 50 states, Washington D.C., and five territories. This is in addition to HRSA’s distribution of American Rescue Plan (ARP) Rural payments, totaling nearly $7.5 billion in funding to more than 44,000 providers since November 2021.
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If you have any further questions, please contact your RCPA Policy Director.
The 2022 RCPA Conference, Together, will be held October 11–14 at the Hershey Lodge as a premier statewide event. The Conference Committee is seeking workshop proposals in every area for possible inclusion. Encouraged presentations are those that assist providers in developing and maintaining high-quality, stable, and effective treatments, services, and agencies in an industry where change is constant. The committee looks for presentations that:
Workshop ideas for 2022 include:
The committee welcomes any proposal that addresses these and other topics essential to rehabilitation, mental health, substance use, children’s, aging, physical disabilities, and intellectual/developmental disabilities & autism. Members are encouraged to consider submitting and to forward this opportunity to those who are exceptionally good speakers and have state-of-the-art information to share.
The Call for Proposals (featuring a complete listing of focus tracks) and accompanying Guidelines for Developing Educational Objectives outline requirements for submissions. Proposals must be submitted electronically on the form provided; confirmation of receipt will be sent. Proposals submitted after the deadline will not be considered.
If the proposal is accepted, individuals must be prepared to present on any day of the conference. Workshops are 90 or 180 minutes in length. At the time of acceptance, presenters will be required to confirm the ability to submit workshop handouts electronically four weeks prior to the conference. Individuals unable to meet this expectation should not submit proposals for consideration.
Individuals are welcome to submit multiple proposals. Notification of inclusion will be made via email by May 13, 2022. Questions may be directed to Sarah Eyster or Carol Ferenz, Conference Coordinators.
We look forward to coming together again this October!