aco reach program sees significant savings growth prompting calls for extension

The ACO REACH program has shown significant growth in savings for 2023, with accountable care organizations (ACOs) reporting substantial savings for the Centers for Medicare & Medicaid Services (CMS).

Program Savings

The program reported gross savings of $1.64 billion and net savings of $694.6 million, a significant increase from the previous year. In 2022, ACOs generated only $371.5 million in savings for CMS. The per-beneficiary per-month gross savings increased by 72% to reach $71.15, demonstrating the effectiveness of the model in delivering cost-efficient care.

ACO Performance

Nearly three-quarters of the ACOs participating in the program achieved positive savings, prompting the National Association of ACOs (NAACOS) to advocate for the extension of the model beyond its current expiration date of 2026. The organization is pushing for CMS to refine and develop new total cost of care models to enhance the quality and affordability of healthcare.

Financial Results

The financial results for the ACO REACH program are based on comparisons to established benchmarks for the 132 participating ACOs in 2023. ACOs that have been part of the program since its inception in 2021 accounted for 64% of the total savings, while newer entrants contributed 36%. High-needs ACOs and new entrants have shown better performance compared to standard ACOs, with high-needs ACOs also reporting higher average quality scores.

Concerns and Future Outlook

The ACO REACH program has led to concerns about potential changes that could impact the participation of new ACOs. Despite the current lack of opportunities for new entrants, the number of participating clinicians has grown, with over 173,000 expected to be involved in 2024. The success of the ACO REACH model has led to advocacy for its extension, as it can drive long-term improvements in healthcare quality and affordability. The focus on value-based care models like ACO REACH will be crucial in addressing the challenges of rising healthcare costs and improving patient outcomes.

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