How to Make the Most of REACH

As ACOs are accepted into REACH, we’re seeing increased – and genuine – excitement about what’s next for value-based care. In fact, the volume of applicants was so high that less than 50% were accepted. If you were one of those lucky enough to make it into the program, congratulations! You’ve likely demonstrated to CMS you’re capable of hitting specific benchmarks to improve population health, such as reducing hospital admissions. REACH has some strict guidelines that participating ACOs must meet, particularly regarding improving health equity.

REACH requires its participants to develop a health equity plan that identifies health disparities in individual markets and explains the specific actions it will take to mitigate the identified health disparities. Organizations will also be required to collect demographic and social determinants of health data from Medicare beneficiaries. What’s more, participants will need an implementation plan for addressing these two elements of the program, which is due to CMS by September 30, 2022.

With the deadline rapidly approaching, here are two facets of REACH you can use to build and submit your plan on time.

1. Beneficiary engagement incentives

The only way to successfully make the most of REACH is to engage eligible patients and encourage them to participate. REACH offers two incentives to help sway those patients and improve health equity in your patient population: the Chronic Disease Management Reward program or the Cost Sharing Support for B services.

Cost Sharing Support for B Services: Many patients with chronic conditions don’t have the resources to seek the level of care they need continually. Too often, chronically ill patients don’t stick to their care plan or miss annual check-ups altogether because co-pay costs are a barrier. This incentive is an opportunity to help them overcome this obstacle to care, applying to outpatient care, preventative services such as vaccines, therapy, home health, ambulance services, and more.

Chronic Disease Management Reward program: With these incentives, patients receive up to $75 each per year for participating in chronic disease management programs. ACOs can get creative with the rewards, offering patients gift cards (stipulations apply) in exchange for following their chronic care plan.

Engooden has a deep and experienced team working on behalf of ACOs. We can manage those waivers on behalf of physicians and ensure underserved individuals are seeing their providers, following their care plans, and that they continue to qualify for these incentives.

2. Health Equity and SDOH

Data collection is another critical component of REACH you should consider when developing your implementation plan. As a REACH participant, you will be required to collect and report beneficiary-reported demographic and social determinants of health data on their aligned beneficiaries.

The key to collecting this data is engaging patients consistently and proactively to truly and deeply understand what affects them beyond their clinical diagnosis. ACOs need to know more about those non-clinical factors, from diet to transportation access, housing and beyond. These determinants of health change frequently, particularly for those without access to care or otherwise experiencing health inequities.

At Engooden, our care navigators use our proprietary technology to collect lifestyle information and share that back to providers. Plus, our care navigators consistently connect with patients one-on-one through trust-based relationships that often result in patients sharing SDOH information they may have otherwise not shared with their provider. Since we collect this beneficiary-reported demographic and SDOH data required for the REACH program, we offer ACOs a consistent, up-to-date window into the factors impacting patient health and inhibiting access to care.

REACH with Engooden

Meeting the REACH requirements will be a long-term investment that will likely require some upfront costs. You might need to put some resources toward coordinating with community health organizations or other nonprofits to reach underserved communities. But understanding the vision of what you want to accomplish through REACH will allow you to prepare and execute a plan by the September 30 deadline.

The Engooden team is ready to help you put your plan together so you can benefit from the REACH program. With deep experience working with ACOs and their Medicare beneficiaries, we understand what it takes to succeed using this new model by enhancing care coordination for patients with chronic diseases.

REACH for Success

For more information about how you can prepare for the September 30 deadline, please listen to our on-demand webinar with David Ault, former CMS CMMI Director, Division of Financial Risk, and current counsel at Ropes & Gray, and Ryan Atwood, Engooden VP of Payer Relations and Regulatory Affairs: REACH for Success: How to Prepare for the New ACO Model, or join us live on Tuesday, August 23, at 1 p.m. EDT for our next webinar, Succeeding in an ACO by Implementing High-Touch, Patient-Centered Care.

Contact us today to learn how Engooden can help you make the most of the REACH model and deliver quality care to your patient populations who need it most.