ACO Realizing Equity, Access, and Community Health (ACO REACH) is a new Medicare program that gives primary care providers an opportunity to improve care delivery and health outcomes for all patients enrolled in traditional Medicare. Under this program, primary care providers(s) can join or form an ACO that can directly contract with the Centers for Medicare & Medicaid Services (CMS) just like a health plan. The ACO REACH model replaces the model known as Direct Contracting, which AdvantageCare Physicians participated in in 2022.
We participate in the ACO REACH model as AdvantageCare ACO. AdvantageCare ACO is located at 55 Water Street, New York, New York 10041. AdvantageCare ACO is a wholly owned subsidiary of AdvantageCare Physicians, P.C. (ACPNY), a participant in the ACO. AdvantageCare ACO does not have any other joint ventures with any of its Participant Providers or Preferred Providers.
AdvantageCare ACO was a high-performing ACO in the MSSP from January 2016 until December 31, 2021, after which we began participating in Global Professional Direct Contracting, now called ACO REACH. During that time, ACPNY generated $38.46 million in total savings for Medicare, which earned ACPNY $18.88 million in shared savings under MSSP. In 2021, ACPNY achieved Medicare savings of $1,264 per beneficiary. According to a recent government evaluation, ACPNY ranked among the highest performing ACOs in New York and in the nation as a whole.
To see a list of the ACPNY providers who are participating in AdvantageCare ACO click here.
Providers who are part of an ACO find that they are able to give their patients better quality care. Medicare benefits for patients seeing an ACO REACH provider will not be changed. However, as a patient of an ACO REACH provider, some special features may be available to you at no extra cost. These special features are listed below:
- Coordination of care between specialists, hospitals, nursing homes and care managers
- Provider registry management to determine care opportunities
- Outreach to patients including phone and email to ensure follow-up as allowed under applicable state regulation or state medical licensing requirements; self-management support and counseling; some behavior change management, case management and disease management
- Medication management
- Care plan follow-up
- Outreach and care management for patients with chronic disease
For information about any of these features, please ask your doctor or healthcare provider. Additionally, the Medicare program tracks quality data about AdvantageCare ACO’s performance as a REACH participant. For example, CMS measures AdvantageCare ACO’s performance on measures of patient satisfaction and patient safety. Once available, AdvantageCare ACO will provide that information here. Please check back later.
