How to determine whether the model is addressing health care disparities, improving quality of care, and reducing health care expenditures.

The Centers for Medicare & Medicaid Services (CMS) is committed to giving Medicare beneficiaries access to health care centered on their needs, with a focus on ensuring health equity. To be most effective, care delivered to Medicare beneficiaries must represent high value, so that using health care leads to better health outcomes. The ACO Realizing Equity, Access, and Community Health (ACO REACH) Model seeks to improve the quality of care and health outcomes for Medicare fee-for-service  beneficiaries through alignment of financial incentives that promote effective and appropriate care.  The goal of the ACO REACH model is to promote health equity, ensure health care providers continue to play a primary role in accountable care, and protect beneficiaries with increased participant vetting, monitoring and transparency.

CMS has partnered with NORC to assess the effectiveness of the model’s ability to improve quality of care and reduce expenditures for Medicare beneficiaries attributed to participating ACOs.

NORC’s evaluation maximizes the use of multiple data sources, building an integrated approach to assess the model’s effectiveness.

NORC’s firsthand knowledge about ACO models—how they evolve over time and how their success reflects factors at the ACO, provider, and beneficiary levels—informs an evaluation framework and design that maximizes the use of data generated from multiple sources. NORC is drawing from these data sources to conduct qualitative multi-case analyses to relate key implementation features to cost, quality, and utilization outcomes.

NORC’s mixed-methods evaluation of ACO REACH will provide CMS with rigorously derived estimates of the model’s impact on utilization and cost; describe and explain nuanced variation in outcomes; and provides a clear understanding of beneficiaries and providers' experiences and ACOs in the model.  These findings will help inform CMS policymakers’ decisions related to the model and other initiatives advancing the agency’s accountable care goals.