Dr Michael Chernew Outlines the Attention to Health Equity in ACO REACH

The accountable care organizations (ACOs) participating in the new ACO REACH model will have a health equity benchmark adjustment and need to collect more data to help better understand the populations being cared for and serve those from underserved communities, said Michael Chernew, PhD, Leonard D. Schaeffer Professor of Health Care Policy and director of the Healthcare Markets and Regulation Lab at Harvard Medical School; chair of the Medicare Payment Advisory Commission; and co-editor-in-chief of The American Journal of Managed Care®.

Transcript:

There is a growing focus on addressing equity and disparities; how can models like ACO REACH address these issues?

They've put a lot of attention to equity in the new ACO REACH model. One of them is there's an adjustment to the benchmark where they give an adjustment based on who you're enrolling and making sure if they're coming from underserved communities, you get a bit of a benchmark bump. So that's one way that it supports equity.

There's a number of other demographic things that they've put in place. So, they want you to collect information so they can get some sense of what's happening with equity, for example. And they allow some enhancement of services, and those types of things.

So, there's a bunch of stuff, I would say the benchmark part is the biggest, where they have worked to make sure that underserved communities will be served and will benefit in the new ACO REACH model.

Do you believe the health equity benchmark adjustment is going to be adequate and do the job?

The proof will be in the pudding. But it is certainly, I think, a step in a direction that is more than where we were historically. So, it's hard to say whether it's adequate or not. It could be too big, it could be too little. That's why we have a learning health care system. I think the advantage of it is that it sort of puts a stake in the ground for setting benchmarks in a way that take equity type issues into account.

In ACO REACH, CMS is putting an emphasis on data collection from beneficiaries—what is the end purpose of that collection and who will it hopefully be used?

I think they're trying to understand how different communities are being served in these new payment models. And I think they want to collect that information on demographics and social need, so, they can try and understand where there are services that might support beneficiaries in ways that we may not have seen without the data being collected. I'm not sure how successful they will be. But I think it's a step to try and understand those issues.