How ACO REACH is Designed to Bring Equity to Healthcare

ACO REACH Targets Essential Healthcare Concerns

The central theme of the ACO REACH model is the movement towards health equity. ACO REACH participants need to submit at least one robust health equity plan, and then implement it. Another aspect that ACO REACH models address is the quality of the provider performance. Without exemplary healthcare performance from practitioners, health equity objectives will be harder to achieve.

Healthcare Disparities

Execution of the health equity plan becomes complicated as it requires diverse technologies to work in tandem. Data management, statistical analytics, and care delivery must work together to complement each other. For this to work, a strong data processing foundation is absolutely necessary. Managing healthcare claims and clinical data from a centralized data repository leads to more efficient and accurate output. The results can then provide a more comprehensive identification of health disparities required in targeting health equity plans. 

Data-based Equity Plans

The identification and analysis of social marker gaps can then be filled in with an appropriate healthy equity plan. The health equity plan can be based on the unique characteristics that are inherent to the beneficiary health population. Once the goals are established, implementing the health equity plan will require strong care management systems. In order to function optimally, the care management system needs to link the insights gained from data analytics. 

Technology will play the most important role in this stage in empowering  care coordination teams. These teams will go through focused tasks based on their capabilities to attain the objectives of the health equity plan. Establishing workflows centered on care coordination and delivery will align patient health goals. These workflows act as opportunities to fill in the gaps to achieve ACO REACH healthcare objectives and business goals.

Provider Network Performance

Healthcare organizations benefit greatly from the ACO REACH model. Opportunities can be found in the agreements between the ACO REACH models and providers. Performance analytics of providers allow ACO REACH participants to evaluate the quality and cost of high-performing health practitioners. Furthermore, ACO REACH participants can even establish innovative payment models such as session-based payment agreements and subcapitation schedules.

This arrangement can benefit both the model and its network of preferred providers. In doing so, the structure can define bundled procedures and prospective prices for common health conditions and events. The lure of prospective bundles and high-performing provider networks add more stability and predictability to ACO REACH models.



Incorporating Technology into Current Healthcare Investments

Healthcare investments encompass a range of resources, which often come in tangible forms to create intangible assets. Brand name awareness, reputation, and performance are some of the non-physical outcomes stemming from physical resources.

Technology is one of the most valuable infrastructure that ACO REACH participants can invest in. The presence and integration of technology into current workflows can enhance productivity and efficiency. This can result in organizations that are well-equipped to handle current and future healthcare administrative needs. 

As a committed supporter of emerging technologies that empower healthcare organizations, MedVision developed QuickCap 7 (QC7). As an integrated value-based healthcare administrative solution, QC7 easily transforms manual workarounds into automated seamless systems. QC7 streamlines complex workflows into efficient processes with intuitive interoperability functionalities. With each data-driven administrative operation flowing throughout the whole work cycle, QC7 allows organizations to focus on more important matters with a few of these capabilities:

• Manage credentialing processes to review provider status
• Monitor and control member eligibility through stringent reviews and approvals
• Handle patient care processing and health plan implementation for improved health outcomes
• Enhance care coordination and delivery through collaborative communication
• Master claims management and processing efficiently from end to end
• Complete private financial transactions through secure electronic data interchange (EDI) protocols

Customizable and intuitive, QC7 transforms all of your essential business processes into one automated workflow. Experience powerful interdisciplinary operations that allow you to target important healthcare objectives. At MedVision, we believe in supporting and empowering organizations like you to reach your full potential.

Explore your possibilities with QuickCap now.

References:

1. Holder, Elizabeth. “ACO REACH Model.” ACO REACH Model. www.naacos.com, June 8, 2022. https://www.naacos.com/aco-reach-model.

2. Pifer, Rebecca. “‘Very False and Misleading’ Criticisms over Direct Contracting Stoked Model Controversy, Stakeholders Say | Healthcare Dive.” Healthcare Dive. www.healthcaredive.com, April 29, 2022. https://www.healthcaredive.com/news/direct-contracting-medicare-reach-cms-controversy/622969/.

3. McKnight’s Long-Term Care News. “ACO REACH Combines Innovation with Access for SNFs - McKnight’s.” www.mcknights.com, March 16, 2022. https://www.mcknights.com/marketplace/marketplace-experts/aco-reach-a-step-toward-innovation-for-snfs/.

Explore Related Blogs