Ten accountable care organizations (ACOs) and several related associations are launching a new Complex Care Alliance focused on improving models of care for the most complex and vulnerable Medicare beneficiaries.
Members include participants in the High Needs ACO model and concerned organizations that are advocating for the Centers for Medicare and Medicaid Services (CMS) and the CMS Innovation Center to strengthen and continue the model beyond its current expiration date in 2026.
The 10 High Needs ACOs in the Complex Care Alliance are Advanced Illness Partners, Bloom Healthcare, CareConnnect MD, Curana Health, Ennoble Care, Essen Health Care, HarmonyCares, Intrinsia Health, Provider Partners Connect Care, and Theoria Medical.
The alliance also has five partner organizations that have contributed to its development and actively support its work. They are Accountable for Health (A4H), the American Academy of Home Care Medicine (AAHCM), America’s Physician Groups (APG), the Coalition to Transform Advanced Care (C-TAC), and the National Association of ACOs (NAACOS).
Established under the Global and Professional Direct Contracting model launched under the Trump Administration, which is now known as ACO Realizing Equity Access and Community Health (REACH), the High Needs model was designed to provide high-quality, coordinated care for Medicare’s sickest patients. The model includes specific flexibilities and design elements tailored to the unique needs and characteristics of these patients, who have an average of 12 chronic conditions and nearly 70 percent of whom are dually eligible for Medicare and Medicaid.
The Alliance notes that the High Needs ACO model has already demonstrated its ability to improve patient outcomes and reduce costs for this population. According to CMS data, 14 High Needs ACOs saved about $143 million in 2023, a 13.3 percent net savings rate. The Complex Care Alliance said it is committed to working with CMS and the Innovation Center to ensure Medicare beneficiaries have continued access to high-needs focused accountable care that meaningfully improves quality of life and reduces program spending.
“We’ve seen firsthand how the High Needs Track of ACO REACH presents an opportunity to better coordinate care for patients with complex, polychronic needs,” said Matt Chance, CEO of Nashville-based HarmonyCares, in a statement. “We will actively work with the Complex Care Alliance to advocate for CMS to continue, strengthen, and expand the program so we may care for our sickest and most vulnerable patients most effectively.”
“Accountable for Health is proud to support the launch of the Complex Care Alliance and its mission of improving care for our sickest and most vulnerable patients,” said Mara McDermott, CEO of Accountable for Health, in a statement. “High-needs patients require proactive, team-based care that is impossible to deliver under a fee-for-service payment system. These organizations have proven that accountable care models deliver better care at reduced costs for this highly specialized population, and we plan to build on this success for years to come.”
