ACO REACH: An Innovative Step Towards Health Equity

By Danélia Botes

October 29, 2023

Understanding ACO REACH and its Impact

Launched in January 2023, Accountable Care Organisation Realising Equity, Access, and Community Health (ACO REACH), initiated by the Centers for Medicare and Medicaid Services (CMS), has taken a strategic leap towards equity in healthcare. The model is designed to promote health equity through payment model design, data collection on social drivers of health, and financial incentives linked to equity.

A key feature of ACO REACH is the Health Equity Benchmark Adjustment (HEBA). This adjustment allows for increases or decreases in participants’ financial benchmarks based on the beneficiaries they serve. The goal? To remove the disincentives to serve marginalised populations by acknowledging the extra costs of caring for these groups.

Changes to HEBA Calculations in 2024

As we move into 2024, Medicare is taking on board stakeholder feedback and revising its approach to HEBA calculations. This change is significant, as it marks one of the first attempts to alter financial targets based on non-medical factors.

The way HEBA scores are calculated will also undergo changes. Currently, the HEBA is based on measures of individual beneficiary income and area-level social need. However, from next year, CMS will incorporate beneficiaries’ state ADI, a measure that ranks the social need in a beneficiary’s neighbourhood against the need in other neighbourhoods across a given state.

The implications of these changes are substantial. They represent a pragmatic way to improve policymakers’ ability to identify individuals with low-income and high health-related need.

In conclusion, ACO REACH is one of the first models to reflect a national call to action for health care stakeholders to go beyond traditional approaches to value-based payment and address equity. 

Reference url

Recent Posts

South African National Health Insurance Bill
          

High Court on South African National Health Insurance Bill

📢Latest update on the NHI! 📢 Dive into our latest piece on the judicial review of the South African National Health Insurance Bill. Learn about the intriguing case and its implications on the healthcare industry. 🏛️💼💡 #HealthcarePolicy #LegalReview #NationalHealthInsuranceBill

Global Perspective on Orphan Medicines
                

A Global Perspective on Orphan Medicines and Rare Diseases

Discover the global perspective on orphan medicines and their role in treating rare diseases. Learn about the unique challenges and incentives in their development. 🌍💊 #OrphanMedicines #RareDiseases #HealthcareInnovation #RareDiseaseDay. Read more here

            

The Impact of Universal Health Coverage on Poverty Reduction in Low and Middle-Income Countries

📚 New research findings alert! 🚨 A recent study shows that increasing coverage of maternal, child and inpatient services is associated with reduced poverty in low and middle-income countries. 💡 This supports pro-poor approaches towards Universal Health Coverage. 🌍 Let’s work together to ensure #HealthForAll and #EndPoverty. Read more here 📖 #UHC #GlobalHealth #HealthEquity

When you partner with Syenza, it’s like a Nuclear Fusion.

Our expertise are combined with yours, and we contribute clinical expertise and advanced degrees in health policy, health economics, systems analysis, public finance, business, and project management. You’ll also feel our high-impact global and local perspectives with cultural intelligence.

SPEAK WITH US

CORRESPONDENCE ADDRESS

1950 W. Corporate Way, Suite 95478
Anaheim, CA 92801, USA

JOIN NEWSLETTER




SERVICES

© 2024 Syenza™. All rights reserved.