ACO REACH Model

The ACO REACH Model provides novel tools and resources for health care providers to work together in an ACO (Accountable Care Organization) to improve the quality of care for people with Original Medicare. REACH ACOs are composed of different types of providers, including primary and specialty care physicians.

The model was redesigned from the Global and Professional Direct Contracting (GPDC) Model, which ran for two performance years (PY 2021 through PY 2022). ACO REACH’s first performance year began on January 1, 2023, and it will run for four performance years (PY 2023 through PY 2026).

Starting in PY 2026, ACO REACH will implement an adjusted financial methodology, as well as other operational changes, to improve model sustainability based on the findings in the Preview of the PY 2023 Evaluation Report.

For more information on these changes, please visit ACO REACH Model PY 2026 Updates.

Key Points
Problem: The health care system can be challenging to navigate, particularly for patients with chronic conditions and those who receive care from multiple providers who do not communicate with each other. These patients often receive unnecessary, repeat diagnostic tests or conflicting treatments for their different health conditions, and their primary care physician, if they have one, may not have a full picture of the treatment received by other providers. Solution: The ACO REACH Model encourages health care providers — including primary and specialty care doctors, hospitals, and others — to come together to form an Accountable Care Organization, or ACO. ACOs break down silos and deliver high-quality, coordinated care to their patients, improve health outcomes, and manage costs. Outcomes: People with Medicare in a REACH ACO get help navigating the health system and managing their conditions. They may have greater access to enhanced benefits, such as telehealth visits, home care after leaving the hospital, and help with co-pays. Strategy: ACOs are critical partners in empowering people to manage their conditions to keep them healthier longer.

Key Points

Problem: The health care system can be challenging to navigate, particularly for patients with chronic conditions and those who receive care from multiple providers who do not communicate with each other. These patients often receive unnecessary, repeat diagnostic tests or conflicting treatments for their different health conditions, and their primary care physician, if they have one, may not have a full picture of the treatment received by other providers.
Solution: The ACO REACH Model encourages health care providers — including primary and specialty care doctors, hospitals, and others — to come together to form an Accountable Care Organization, or ACO. ACOs break down silos and deliver high-quality, coordinated care to their patients, improve health outcomes, and manage costs.
Outcomes: People with Medicare in a REACH ACO get help navigating the health system and managing their conditions. They may have greater access to enhanced benefits, such as telehealth visits, home care after leaving the hospital, and help with co-pays.
Strategy: ACOs are critical partners in empowering people to manage their conditions to keep them healthier longer.

Model Details

ACO REACH builds on lessons learned from earlier shared-savings, ACO models, encouraging health care providers to form ACOs to break down silos and deliver high-quality, coordinated care to their patients, improve health outcomes, and manage costs. The model makes important changes to the previous GPDC Model, including 1) policies that promote health care provider leadership and governance and participation of beneficiary advocates on the governing board and 2) greater participant vetting, monitoring, and transparency to protect patients and the model.

Aims

The model seeks to improve quality of care and health outcomes for people with Medicare through:

Alignment of financial incentives.
Emphasis on patient choice and care delivery.
Strong monitoring to ensure that patients maintain access to care.

Innovation

There are two voluntary risk-sharing options under the ACO REACH Model. In each option, participating providers accept Medicare claims reductions and agree to receive at least some compensation from their ACO.

Professional: A lower risk-sharing arrangement — 50% savings/losses — with one payment option for participants: Primary Care Capitation Payment, a risk-adjusted monthly payment for primary care services provided by the ACO’s participating providers.
Global: A higher risk sharing arrangement — 100% savings/losses — with two payment options: Primary Care Capitation Payment (described above) or Total Care Capitation Payment, a risk-adjusted monthly payment for all covered services, including specialty care, provided by the ACO’s participating providers.

Design

The ACO REACH Model is focused on provider-based organizations and offers three types of participants:

Standard ACOs: ACOs composed of organizations that generally have experience serving Original Medicare patients, including Medicare-only and also dually eligible beneficiaries, who are aligned to an ACO through voluntary alignment or claims-based alignment. These organizations may have previously participated in another CMS Innovation Center shared-savings model (e.g., Next Generation ACO Model and Pioneer ACO Model) and/or the Center for Medicare’s Shared Savings Program. Alternatively, new organizations, composed of existing Original Medicare providers and suppliers, may be created to form a Standard ACO. In either case, clinicians participating within these organizations would have substantial experience serving Original Medicare beneficiaries.
New Entrant ACOs: ACOs composed of organizations that have not traditionally provided services to an Original Medicare population and who may rely primarily on voluntary alignment, at least in the first few performance years of model participation. Claims-based alignment will also be utilized.
High Needs Population ACOs: ACOs that serve Original Medicare patients with complex needs, including dually eligible beneficiaries, who are aligned to an ACO through voluntary alignment or claims-based alignment. These participants are expected to use a model of care designed to serve individuals with complex needs, such as the one employed by the Programs of All-Inclusive Care for the Elderly (PACE), to coordinate care for their aligned beneficiaries.

Participant Information

Evaluation Reports

Additional Information

Stay Connected

For additional information and updates specifically about the ACO REACH Model, please subscribe to the ACO REACH Model listserv.
Contact the ACO REACH Model team at ACOREACH@cms.hhs.gov.
For CMS Innovation Center updates, subscribe to the CMS Innovation Center listserv.

Visit our Innovation Models webpage for a list of all CMS Innovation Center model tests.

Helpful Resources

Model Summary

Stage: Active
Number of Participants: 103
Category: Accountable Care Models
Authority: Section 1115A of the Social Security Act

Latest Evaluation Report

Get the most recent evaluation findings about ACO REACH:
PY 2023 Preview (PDF)

CMS Innovation Center Highlights

Learn about topics that play a critical role in our work on our Key Concepts webpage.

Read stories about our work in action on the Value-Based Care Spotlight.

Page Last Modified:

12/03/2025 12:17 PM

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ACO REACH Model

Model Details

Aims

Innovation

Design

Participant Information

Transparency and Data Sharing

Participant Resources

Methodology Papers

Evaluation Reports

Latest Evaluation Report

Financial and Quality Results

Additional Information

Stay Connected

Helpful Resources

Model Summary

Latest Evaluation Report

CMS Innovation Center Highlights