The advocacy organization Accountable for Health is part of the Complex Care Alliance, a coalition of advocates for a Medicare payment model that works with physicians and other health care providers to coordinate health care for medically complex patients. CEO Mara McDermott, JD, explains more.
Medical Economics: Accountable for care is involved with another group, the complex Care Alliance. Can you explain what that is?
Mara McDermott, JD: Absolutely. So the ACO REACH model, before a couple of weeks ago, it was unclear where that model was going to go. Within ACO REACH, there are a couple of different ways to participate. One of the ways to participate is as a high-needs ACO REACH, and those are ACO REACH entities that take care of a really complex population. Patients tend to be homebound, I think on average, they have 12 or more comorbidities, so really complex patient populations. The Complex Care Alliance was created to ensure that there is a pathway forward for organizations that have taken on those complex populations. That model is unique. It has its own risk adjustment, its own benchmarking, its own attribution and alignment strategies. In many ways, it’s quite different from the way the Medicare Shared Savings Program exists today, and from the way that standard ACO REACH exists today. The group was founded to make sure that those important differences, differences that make the business go, were incorporated in LEAD. We are thrilled to say that we still we see a commitment to that direction in the initial LEAD announcement, and now that group will be continuing to work as we see the financial methodology and other details of the LEAD model to advocate with CMS, that they get that right, that those organizations can continue to be successful.
