Opportunities and Obstacles for Private Equity and Other Stakeholders in Revamped Direct Contracting Entity Model

CMMI recently announced a major overhaul to its Direct Contracting Entity (DCE) Model — renamed the ACO Realizing Equity, Access and Community Health (REACH) Model. As the new name implies, CMMI revised the Direct Contracting Entity (DCE) Model to function more like the Next Generation and MSSP models, with a significant focus on reducing disparities in health status and outcomes, especially for underserved populations. In addition, new ACO REACH model features are aimed at reducing the influence of outside (i.e., non-physician) investors and parent companies in key ACO operations. These changes may cause potential REACH participants and would-be investors to reconsider participating in the model. 

Other significant changes to the DCE/REACH program include:

• Outside investors control capped at 25% of ACO governing body (formerly 75%) 
• Heavy focus on implementation of health equity initiatives across the ACO’s entire population
• Greater emphasis on transparency, audits and reporting
• Prior experience with underserved populations
• Benefit enhancements and beneficiary incentives

Attendees Will Learn:

• Key differences between former DCE and new ACO Reach Models
• How to develop a strong ACO Reach model participation application
• Establishing a governance structure that complies with the new 25% cap but also affords investor control of certain ACO functions
• Opportunities for providers who are new to fee-for-service Medicare
• How to leverage prior experience with risk arrangements with commercial populations

Time

9:00 - 10:00 a.m. PT
10:00 - 11:00 a.m. MT
11:00 a.m. - Noon CT
Noon - 1:00 p.m. ET
5:00 - 6:00 p.m. BST

Questions? Please contact Angela Wood or call +1 303 607 3662.