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Alternatively, new organizations, composed of existing Original Medicare providers and suppliers, may be created to form a Standard ACO. These organizations may have previously participated in another CMS Innovation Center shared savings model (e.g., Next Generation ACO Model and Pioneer ACO Model) and/or the Shared Savings Program. Standard ACOs – ACOs comprised of organizations that generally have experience serving Original Medicare patients, including Medicare-only and also dually eligible beneficiaries, who are aligned to an ACO through voluntary alignment or claims-based alignment.The ACO REACH Model is focused on provider-based organizations and offers three types of participants: Current GPDC Model participants must maintain a strong compliance record and agree to meet requirements for the redesigned model by Januin order to continue their participation. Accepted applicants will have the option of participating in an Implementation Period leading up to PY2023, which runs from Augthrough December 31, 2022. CMS has released a Request for Applications (RFA) for organizations interested in beginning participation in PY2023. The first Performance Year of the redesigned model will begin on Januand will run for four Performance Years: Performance Year 2023 (PY2023) through PY2026. Please see the ACO REACH GPDC Comparison Table for a comprehensive set of policy updates. Last, CMS will also explore stronger protections against inappropriate coding and risk score growth. We will employ increased up-front screening of applicants, robust monitoring of participants, and greater transparency into the model’s progress during implementation, even before final evaluation results, and will share more information on the participants and their work to improve care. CMS will ask for additional information on applicants’ ownership, leadership, and governing board to gain better visibility into ownership interests and affiliations to ensure participants’ interests align with CMS’s vision. Protect Beneficiaries and the Model with More Participant Vetting, Monitoring and Greater Transparency.

In addition, the ACO REACH Model goes beyond prior ACO initiatives by requiring at least two beneficiary advocates on the governing board (at least one Medicare beneficiary and at least one consumer advocate), both of whom must hold voting rights. At least 75% control of each ACO's governing body generally must be held by participating providers or their designated representatives, compared to 25% during the first two Performance Years of the GPDC Model. The ACO REACH Model includes policies to ensure doctors and other health care providers continue to play a primary role in accountable care. Promote Provider Leadership and Governance.

ACO REACH will test an innovative payment approach to better support care delivery and coordination for patients in underserved communities and will require that all model participants develop and implement a robust health equity plan to identify underserved communities and implement initiatives to measurably reduce health disparities within their beneficiary populations.

Advance Health Equity to Bring the Benefits of Accountable Care to Underserved Communities. The ACO REACH model promotes health equity and focuses on bringing the benefits of accountable care to Medicare beneficiaries in underserved communities.

ACO REACH will enable CMS to test an ACO model that can inform the Medicare Shared Savings Program and future models by making important changes to the GPDC Model in three areas: The redesigned ACO REACH Model reflects the priorities of the Biden-Harris Administration and responds to feedback from stakeholders and participants. Current GPDC Model participants must maintain a strong compliance record and agree to meet all the ACO REACH Model requirements by Januto continue participating in the ACO REACH Model as ACOs. The new cohort will begin participation in the ACO REACH Model on January 1, 2023. CMS is renaming the model the ACO REACH Model to better align the name with the purpose of the model: to improve the quality of care for people with Medicare through better care coordination, reaching and connecting health care providers and beneficiaries, including those beneficiaries who are underserved, a priority of the Biden-Harris Administration.

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The Centers for Medicare & Medicaid Services (CMS) has redesigned the Global and Professional Direct Contracting Model (GPDC) Model in response to Administration priorities, including our commitment to advancing health equity, stakeholder feedback, and participant experience. The Center for Medicare and Medicaid Innovation (Innovation Center) is releasing a Request for Applications (RFA) to solicit a cohort of participants for the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model.