CMS Expands Accountable Care Initiatives to Bolster Medicare Enrollees’ Care Access

Three accountable care initiatives will expand in 2023, a move which is intended to increase Traditional Medicare beneficiaries’ access to quality care, according to a press release by the Centers for Medicare & Medicaid Services (CMS).

CMS announced expansions to the Medicare Shared Savings Program; the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model; and the Kidney Care Choices (KCC) Model.

The Shared Savings Program is the largest of the 3 initiatives, involving 456 ACOs and 10.9 million assigned beneficiaries in 2023. Once they take effect, policies included in the CY 2023 Medicare Physician Fee Schedule final rule are expected to bolster the number of organizations participating in the Shared Savings Program, especially in underserved areas, the press release said. CMS anticipates the number of Medicare beneficiaries assigned to an ACO under the Shared Savings Program will increase by up to 4 million over the next several years.

Approximately 2.1 million beneficiaries access care through the ACO REACH Model, which currently includes 132 ACOs comprised of 131,772 providers and organizations. ACO REACH will expand in 2023 to include 824 federally qualified health centers, rural health centers, and critical access hospitals, more than doubling the number of organizations that participated in the previous year.

Lastly, the KCC Model will include 130 entities in 2023, supporting an 87% increase in the number of participating providers and organizations, as well as a 62% increase in the number of assigned beneficiaries. The initiative, which is designed to support care coordination and access for beneficiaries with stages 4 and 5 chronic kidney disease and end-stage renal disease, will also expand to new geographic areas including North Dakota and South Dakota.

“Through the CMS accountable care initiatives and working with our partners, we have made significant progress in addressing our greatest health care challenges,” said CMS Administrator Chiquita Brooks-LaSure. “Health care providers coming together as Accountable Care Organizations provide high quality and equitable care to people with Medicare while improving the sustainability of the Medicare program.”

Reference:
CMS announces increase in 2023 in organizations and beneficiaries benefiting from coordinated care in accountable care relationship. News release. Centers for Medicare & Medicaid Services; January 17, 2023. Accessed January 18, 2023. https://www.cms.gov/newsroom/press-releases/cms-announces-increase-2023-organizations-and-beneficiaries-benefiting-coordinated-care-accountable