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What is the ACO REACH Model?

The ACO REACH Model is an accountable care organization (ACO) model that builds upon the Next Generation ACO, Medicare Shared Savings Program (MSSP) and Medicare Advantage (MA), serving as the highest risk/reward ACO model for Medicare FFS.  Existing Direct Contracting Entities (DCEs) may participate without reapplication. Previously, new applications for Direct Contracting were suspended, leaving organizations without the ability to directly enter the model. This presents a new opportunity for those interested in the alternative payment mechanisms, level of risk and incentives provided under DC and now ACO REACH.

What are the benefits of ACO REACH?

  • Access to three (3) years Medicare claims data at the point of care for your patients
  • Improved HCC Risk Coding
  • Eligible for Qualifying APM Participant (QP) determinations
  • Opportunity to align more Medicare patients to your provider for better care coordination
  • Individual clinicians will get $45 incentive payment per FFS visit
  • Practices >20 Providers)
    • Automatically receive the 5% MIPS bonus
    • $5PMPM (Per Member Per Month) for aligned beneficiaries the organization gets to keep


Tamara Finn





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