REACH, data, and the future of chronic disease management

“This is something we should all care about because these are the people around us every day. Loved ones or strangers, it makes no difference. If people can’t get access to health in an equitable way and get the care they need at the right time, it impacts all of us. Whether it’s something as simple as wait times, access or financial implications, it affects everyone.” - Ryan Atwood, VP of Payer Relations and Regulatory Compliance at Engooden Health

(Access Ryan's full commentary alongside Lyndsey Lord, Co-Founder and COO at TribeHealth in our on-demand webinar: Establishing Chronic Disease Programs Under the REACH Model)

We're excited that the Centers for Medicare & Medicaid Services (CMS) has redesigned the Global and Professional Direct Contracting (GPDC) Model, making substantial efforts to get the data necessary to improve care coordination and overcome general barriers to care, particularly for those populations that experience health inequity. The newly announced model, now called ACO REACH, retains many of the same elements of the GPDC model. However, this new version better addresses health inequities and disparities to ensure that Medicare beneficiaries are getting access to the care and resources they need. The ACO REACH model strives to create an equal playing field for all Medicare beneficiaries and one that is genuinely person-centered and focused on individuals.

What is the ACO REACH program?
With its new structure, GPDC is now the Accountable Care Organization Realizing Equity, Access, and Community Health model. This initiative will encourage health care providers to enhance coordination and improve the care offered to Medicare beneficiaries, especially underserved ones. The care coordination aspect is critical. Health systems have an incredible opportunity to strengthen coordination, even within their systems, whether from a hospital to a medical group or a hospital to a skilled nursing facility.

The first Performance Year of the new model begins on January 1, 2023, and will run for four Performance Years. Under this new model, participants must create a robust health equity plan to identify underserved communities and implement actions to reduce health disparities in their beneficiary populations. REACH will introduce a health equity benchmark adjustment to payments to support entities delivering and coordinating care in underserved areas. Additionally, CMS will implement more rigorous screening protocols for applicants and closely monitor participants to ensure compliance with beneficiary protections.

Measuring equity
One of the most significant developments of ACO REACH is its Health Equity Data Collection Requirement, a monumental step toward reliably identifying beneficiaries who face social disadvantages. Participating providers will now be required to collect and report data on their beneficiaries' demographic and social needs and enhance the range of services offered to improve access to care. It's difficult to improve what we don't measure, so creating new equity metrics that reveal how marginalized communities fare under REACH will be instrumental long-term in breaking down barriers to care.

A new day for chronic disease management
At Engooden, each day we see how much health is determined by circumstances outside the clinical walls and the importance of addressing these factors to improve patient health. So many patients, particularly in underserved communities, don't have the means or knowledge to follow their doctor's recommendations, whether filling a prescription, adjusting their diet, or showing up to a follow-up appointment. Health systems across the country rely on Engooden to manage their chronic disease management efforts because we have a proven model for hiring personnel with the expertise to deliver safe, effective, and scalable care.

The revised REACH model is an encouraging step in the right direction of advancing health equity, but data and insights alone won’t fulfill this goal. It takes a personal touch, trust, and real relationships to truly make an impact on patient outcomes. We know this because the success of our chronic disease management services is rooted in meaningful connections. Our care navigators nurture patient relationships each day that allow them to break down barriers and help patients take control of their own health.

Contact us today and learn how Engooden can help you leverage the benefits of REACH and support your most vulnerable patient populations.