What is ACO REACH?

The goal of every home care agency should be to provide high-quality care in every aspect.

Have you thought about promoting equity and access into your operations? 

ACO REACH aims to do just that, and we’ll share all about it with you.

What is an ACO?

An ACO is an Accountable Care Organization. ACOs consist of a network of healthcare providers from a variety of disciplines who are accountable for the oversight and provision of Medicare patient care.

They can, include, for example: 

• Doctors
• Hospitals
• Other healthcare professionals

These professionals and entities gather together to provide comprehensive care to a select group of Medicare patients.

Some of the benefits of care through an ACO are:

1. Lower cost care
2. Shared cost savings (from the federal government)
3. Higher quality care
4. Highly coordinated care
5. Increased healthcare access

What is ACO REACH?

ACO REACH is an acronym that stands for Accountable Care Organization Realizing Equity, Access, and Community Health. 

ACO REACH is a current pilot program for Traditional Medicare beneficiaries that aims to promote equity, access, and community health. Did you know that there are approximately 30 million people who utilize Traditional Medicare? 

This represents the large opportunity at-hand for your agency to partner with ACO networks in your community and join their mission to provide highly coordinated care with a steady stream of new clients. 

REACH, in particular, is focused on partnering with “underserved communities and make measurable changes to address health disparities,” according to CMS. “Additionally, the model uses an innovative payment approach to better support care delivery and coordination for people in underserved communities,” they added. 

The opportunity for home care providers

One of the other main items to note about ACO REACH is the onus that healthcare professionals take on. This is a great opportunity to be a voice at the table where healthcare decisions are being made while reducing overall healthcare spend. 

If you’re interested, here are some immediate actions to take:

Think of this as Medicaid (let us explain). 

If you already bill Medicaid and serve clients, the administrative processes that an ACO uses will be fairly similar (if not easier). Different payer-provider sources may look a bit different, but being familiar with Medicaid billing processes can be a huge advantage for your agency. 

Diversifying your payer mix with ACO REACH is a great opportunity and you can read more about payer mix here.

Join or establish relationships with local ACOs. 

According to the AHA, there are 480 ACOs across the country, including 122 that are enrolled in the ACO REACH pilot program.

Market these opportunities to families in your area.

Medicare might not pay for all of the care that a client needs, but being able to serve people who live in underserved communities means that they’re already missing out on essential care. 

By working with an ACO and promoting health equity and removing disparities, you can help bridge gaps and be the eyes and ears for a beneficiary’s primary care physician—and ultimately, their entire care team. 

Utilize an agency management system built for multiple payers.

Do you see opportunity and promise in ACO REACH? We’re here to support you.

CareTime is a home care agency management system built for growth at your pace, and supporting as many payers as you want to serve. One of our newest features is Billing While You Sleep, a feature that submits claims overnight on your behalf. Wake up to your new favorite notification along with a cup of coffee. Schedule your demo here.