When it comes to joining an Accountable Care Organization (ACO), practices have a few options, each offering unique benefits. The Medicare Shared Savings Program (MSSP) and the newer ACO REACH model are two popular models. Understanding the differences between them can help you make the best decision for your practice’s growth, financial stability, and long-term success.
MSSP: The Right Choice for Newer ACOs or Low-Risk Practices
The MSSP is ideal for practices that are new to the world of value-based care or prefer a lower-risk approach. This model provides the opportunity to earn shared savings based on improved care coordination and cost management. Here are the key benefits:
- Lower Financial Risk: MSSP offers tracks with limited downside risk, making it a safe entry point for practices just starting out with ACOs.
- Simpler Operations: The program is less administratively complex, with fewer reporting requirements compared to more advanced models like REACH.
- Scalable Participation: Start with upside-only risk (Track 1) and gradually transition to more risk-based arrangements as your practice grows.
- Predictable Financial Outcomes: The benchmarks and cost savings calculations are more standardized, which can make financial forecasting easier for new participants.
While MSSP is a great option for practices with limited experience in value-based care, it can be restrictive for those looking to take on more risk and achieve higher rewards.
REACH: A Game-Changer for Practices Ready to Innovate and Maximize Financial Rewards
If your practice is ready to take on two-sided risk and you’re looking to push the boundaries of patient care and financial performance, ACO REACH might be the right fit. Here’s why:
- Higher Earnings Potential: REACH offers the opportunity to share in up to 100% of savings, giving your practice a chance to significantly increase its revenue as you improve care coordination and patient outcomes.
- Tailored Benchmarks: REACH offers more flexible and accurate benchmarking, accounting for patient demographics and social determinants of health (SDOH). This helps practices that serve vulnerable or underserved populations to thrive.
- Greater Innovation in Care: With REACH, you can offer a variety of additional benefits to patients, such as telehealth, transportation services, and care management, to improve outcomes and reduce costs.
- Focus on Health Equity: The REACH model includes a strong emphasis on addressing health disparities, making it the perfect fit for practices dedicated to improving access and care for underserved communities.
- Predictable Revenue Stream: REACH allows for monthly capitation payments for primary care services, which provides stable cash flow and the ability to invest in care management infrastructure.
- Access to Better Data: The REACH model gives you access to near real-time claims data, allowing you to monitor patient outcomes, identify trends, and manage risks more effectively.
If your practice is committed to making a big impact on patient care and financial performance, REACH offers the tools and incentives to help you succeed at a larger scale.
Which Model Is Right for Your Practice?
Choosing between MSSP and REACH ultimately depends on your practice’s goals, resources, and readiness for risk. MSSP is an excellent starting point for newer ACOs or those who prefer a lower-risk model with simpler operations. On the other hand, REACH offers practices ready to innovate and take on more risk the potential for greater financial rewards and the ability to drive real change in patient care and health equity.
If your practice is ready to take the next step in value-based care, REACH may be the ideal choice to maximize growth and impact. However, if you’re still evaluating your readiness for full-risk arrangements, MSSP is a great starting point for building your ACO infrastructure.
Navigating the complexities of choosing between MSSP and ACO REACH can be daunting. At Vytalize Health, we not only provide a unique value-based care solution for partner providers, we also specialize in thoroughly understanding their unique needs to place them in the program where they will thrive. Vytalize also allows practices to focus on what they do best—providing care—without the burden of assuming risk.
As the healthcare landscape continues to evolve, these ACO models will be instrumental in shaping the future of patient care. Contact Vytalize Health today to learn more about these models and our Early Start program. Spots are limited – don’t miss out.
