Equality Health Selected for CMS Direct Contracting Payment Model Program
Innovative, value-based program will enhance care quality for Medicare beneficiaries, reduce administrative burden for primary care providers, and provide Equality Health with a glidepath to ACO REACH
PHOENIX, April 19, 2022 — Equality Health, a leading provider of value-based physician networks uniquely equipped to address the needs of diverse and historically underserved populations, announced that it has been accepted as a Direct Contracting Entity (DCE) in Arizona, under the name “Equality Health Direct.” The innovative federal program, Global and Professional Direct Contracting (“Direct Contracting” or GPDC), supports coordinated care for Medicare beneficiaries by helping primary care providers coordinate care across multiple settings, spend more time with patients with complex conditions, and improve patient outcomes.
The GPDC program, administered by the Centers for Medicare and Medicaid Services (CMS) and its Center for Medicare & Medicaid Innovation (CMMI), is among the most dramatic steps ever taken toward advancing value-based models at scale, and is the latest development in CMS’ long-standing commitment to accountable care. The program builds on more than a decade of focused, bipartisan progress toward an accountable care model that recognizes and rewards primary care providers for delivering more holistic, ‘whole-person’ care to Medicare populations. By participating in this program with Equality Health, provider partners can unlock additional home- and community-based services for patients, including Equality Health’s entire portfolio of clinical support programs that address socioeconomic barriers to care. Equality Health Direct is participating in the second cohort of the program, which began January 1, 2022.
Participating in Direct Contracting also provides Equality Health with a clear pathway to the new health equity-focused alternative payment model, ACO REACH (Accountable Care Organization Realizing Equity, Access, and Community Health). The recently announced ACO REACH model, which will replace the GPDC program on January 1, 2023, builds on CMMI’s longstanding vision to promote accountable healthcare delivery. ACO REACH will employ an innovative payment approach to better support care delivery and coordination for patients in underserved communities. It will also require that all participants develop and implement a robust health equity plan to identify underserved communities and implement initiatives to measurably reduce health disparities within their beneficiary populations.
“Equality Health has always believed that value-based payment models can act as powerful vehicles for promoting health equity and addressing the social determinants of health for underserved populations,” said Brandon Clark, chief strategy officer at Equality Health. “We are absolutely thrilled to see CMMI embed this philosophy into the core design of the next wave of accountable care programs.”
With deep experience in technology-driven primary care transformation across Medicaid, ACA Exchange, Medicare Advantage, and dually eligible populations, Equality Health is well-positioned to empower its primary care partners with the tools, training, practice management support, and aligned incentives to succeed in Direct Contracting. Equality Health welcomes inquiries from primary care practices and specialists interested in exploring participation in Direct Contracting in partnership with Equality Health Direct. To learn more please visit: https://www.equalityhealth.com/direct/.
The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.
About Equality Health
Equality Health, LLC is a Phoenix-based whole-health delivery system focused on transforming value-based care delivery with population specific programs that improve access, quality, and member trust. Through an integrated technology and services platform, culturally competent provider network and personalized care model, Equality Health helps managed care plans and health systems improve outcomes for diverse populations while simultaneously making the transition to risk-based accountability. For more information about Equality Health, visit www.equalityhealth.com or follow @EqualityHealth on Facebook, @EqualityHealth on Twitter, and @EqualityHealth on LinkedIn.
Amendola Communications (for Equality Health)