CVS Health ACO Partnership Expands Value-Based Care in Long Island

CVS Health is partnering with Catholic Health to expand value-based care for Medicare beneficiaries through the ACO Realizing Equity, Access, and Community Health (REACH) program.

Under the ACO REACH program, CVS Accountable Care Organization (CVS ACO) and Catholic Health Physician Partner’s ACO (Catholic Health) will jointly assume accountability for nearly 40,000 Medicare beneficiaries in Long Island, New York. Specifically, the collaboration will provide accountable care for beneficiaries in Nassau and Suffolk counties.

The partnership aims to improve care coordination by providing beneficiaries with personalized support, including home-based care, transportation services for annual wellness visits, and resources to help address social determinants of health.

The initiative will benefit Catholic Health providers and improve the health system’s care delivery by adding same-day access, multidisciplinary chronic condition care management programs, and analytics capabilities, according to the press release.

Additionally, the collaboration will utilize value-based payment models to incentivize providers to deliver quality care.

“We know value-based care, particularly for Medicare beneficiaries, can help dramatically improve outcomes for patients who need it most and achieve lower costs,” Mohamed Diab, MD, chief executive officer of CVS ACO, said in the press release. “That’s why value-based care as a framework is central to our broader care delivery strategy. CVS ACO is bringing to the table powerful tools to help provide coordinated, high-quality care to Medicare patients.”

CVS ACO will participate in the Centers for Medicare and Medicaid Innovation’s (CMMI) ACO REACH model, which replaced the direct contracting model. The ACO REACH program prioritizes provider-led participants, health equity, and care coordination as it works to reduce healthcare costs.

The program allows CVS ACO to support providers through community-based assets, like MinuteClinic retail health clinics, according to Diab. In addition, CVS ACO leverages data analytics and electronic medical record technology to help providers care for complex patients.

The ACO REACH program also assists providers with administrative tasks such as appointment and lab scheduling and provides insights to help providers deliver more personalized care.

Catholic Health is the only health system in the Long Island area participating in the CVS Health ACO REACH program, the press release noted.

“Catholic Health looks forward to working with CVS ACO and bringing these important care enhancements to our Medicare population,” Patrick O’Shaughnessy, DO, MBA, president and chief executive officer of Catholic Health, said. “As CVS’s exclusive health system partner in the Long Island market, we will be able to reach more patients as a unified resource and will provide new equity-focused clinical programs and services at a time when access to high-quality health care is more important than ever.”

Catholic Health’s ACO has previously seen success in the Medicare Shared Savings Program (MSSP), according to the health system.

With this collaboration, Catholic Health will join clinically integrated networks, primary care groups, and federally qualified health centers currently working in the CVS ACO framework.