ACO REACH: Realizing Equity, Access, and Community Health
ACO REACH is the CMS Innovation Center's successor to Direct Contracting. Provider-led ACOs take meaningful downside risk on Medicare fee-for-service spend, with a global capitation payment option and explicit health-equity benchmarking requirements.
How REACH differs from MSSP
- Risk model — REACH ACOs all carry downside risk; MSSP has both upside-only (Track 1) and risk-bearing tracks.
- Capitation option — REACH offers Global Capitation (full PMPM payment) or Professional Capitation (primary care services only). MSSP is fee-for-service with shared savings/losses.
- Equity — REACH includes a health equity benchmark adjustment, rewarding ACOs that reduce disparities in their attributed population.
- Beneficiary engagement — voluntary alignment + benefit enhancements in REACH; mostly claims-based attribution in MSSP.
Why REACH analytics is harder than MSSP
REACH ACOs need to track attributed-population spend continuously (not just at reconciliation), maintain accurate HCC coding for benchmark adjustment, monitor health equity stratification (race, ethnicity, dual eligibility, low-income subsidy), and manage the cash-flow implications of capitation payments. Most ACOs under-invest in continuous analytics and over-rely on the year-end CMS reconciliation report.
Where Vizier fits
Vizier surfaces continuous attributed-population analytics, HCC documentation gaps, and health equity stratification for REACH ACOs. The combination of EHR-pulled clinical data and CMS-shared CCLF (Claim and Claim Line Feed) data gives a continuous reconciliation view — what the year-end CMS calculation will most likely show.