ACO REACH has been an interesting program for many reasons, chiefly because it aligns incentives among many different kinds of providers including primary and specialty care physicians. Additionally, primary care-led ACOs tend to outperform others given their focus on team-based, coordinated care.
Over time, it is not unusual to see the bar raised as organizations gain experience with value-based approaches. In this vein, CMS has announced changes for the 2026 performance year to “improve model sustainability” including:
- Increasing the portion of benchmark that is historical (as contrasted with regional) to 60%
- Adding a 3% cap on risk score growth from 2019 to 2026 (quality withhold goes from 2% to 5%)
- Boosting the coding intensity factor ceiling for high-needs ACOs from 1% to 2%
The ACO Reach demonstration is scheduled to end on December 31, 2026, and some think that the changes improve the likelihood that the program will be extended.
Michigan Multipayer Initiatives 