The Centers for Medicare & Medicaid Services (CMS) announced changes to its Accountable Care Organization Realizing Equity, Access, and Community Health Model (ACO REACH) starting in performance year 2024 to advance health equity and make the model more predictable for participants and more consistent with other CMS programs and models. The changes include:

• lowering the beneficiary alignment minimums across all tracks;
• expanding the alignment for the High Needs Population track to include beneficiaries that have at least 90 Medicare-covered days of Home Health services utilization or at least 45 Medicare-covered days in a Skilled Nursing Facility within the previous 12 months;
• shifting the risk adjustment model to a standard Part C model for standard and new entrant ACOs;
• revising the composite measure used for the Health Equity Benchmark Adjustment (HEBA) to incorporate low-income subsidy status and state-based area deprivation index to better identify underserved beneficiaries living in high-cost areas; and
• allowing participating nurse practitioners and physician assistants to certify and order pulmonary rehabilitation care plans for beneficiaries with chronic obstructive pulmonary disease.

LeadingAge will review this information in the coming weeks and put out more information if needed.