Renown ACO REACH – Fighting the Good Fight for Medicare Members
Renown Direct Contracting Entity, LLC, also called Renown ACO REACH, is participating in a new program with Centers for Medicare & Medicaid Services (CMS) called ACO REACH (Accountable Care Organizations Realizing Equity, Access and Community Health). This program is specifically for patients with Original Medicare who receive a majority of their care from Renown Medical Group. The goal of Renown’s Medicare REACH program is to help providers work together to improve patients’ health by better coordinating care, ensure the highest quality patient outcomes, reducing unnecessary costs, and addressing inequity in care.
As a Medicare beneficiary, you have the opportunity to “Choose Renown” as the main place you go for routine medical care if you like. The process to “Choose Renown” is called Voluntary Alignment. When you voluntarily align with Renown’s Medicare REACH Program, you are confirming with Medicare that Renown Health is where you plan to receive care.
The Renown’s Medicare REACH Program, legally identified as Renown Direct Contracting Entity, LLC (Renown DCE), has contracted with the Centers for Medicare & Medicaid Services (CMS) to participate in the ACO REACH (Accountable Care Organizations Realizing Equity, Access and Community Health) Model. Renown DCE is not an insurance company. It is comprised of health care providers associated with Renown Medical Group.
How is this different from the Direct Contracting Entity (DCE) program I participated in during 2022?
The programs are the same, except that the ACO REACH model expands on the Direct Contracting Model (DCE) by focusing on health equity and addressing health disparities in our community. Medicare members who were in the DCE during 2022 will move to ACO REACH for 2023.
Do my Medicare Benefits change from being in Renown's Medicare REACH Program?
No. Your Medicare Benefits have not changed. You will still be able to see all your Medicare providers and have access to all your current benefits. In addition to those benefits, being a member of Renown’s Medicare REACH Program may also make you eligible for additional services such as care management at no cost to you.
Where can I learn more about Renown’s Medicare REACH Program?
As Medicare beneficiary, what benefits am I eligible for if I join the Renown’s Medicare REACH Program? Will I save money?
Renown Health strives to support patients in the prevention and management of complex health issues. As a part of our service to the community, patients who participate in the Renown’s Medicare REACH Program will have access to care management services not typically available to those with Original Medicare.
Qualifying members will receive support from their care manager, assisting in areas like understanding and building confidence around their health needs, navigating the healthcare system, getting the most out of their medications, and keeping up with routine care. If you qualify and choose to enroll in the program, you will save money as we'll cover the cost of your service so you can focus on what's most important - your health and well-being.
While more new benefits will be added to the Renown’s Medicare REACH Program over time, Medicare beneficiaries who join today can enjoy the peace of mind that comes from knowing Renown Health’s care management team is in your corner.
Will my costs go up if I join Renown's Medicare REACH Program
No. Your costs will not increase. You will still be able to see all your Medicare providers and have access to all your current benefits. In addition to those benefits, being a member of Renown’s Medicare REACH Program may also make you eligible for additional services such as care management at no cost to you.
Can I use my Medicare supplement plan if I join Renown ACO REACH?
Yes. You can continue to use your Medicare supplement plan; it will continue to pay any out-of-pocket costs even if you are a part of Renown’s Medicare REACH program.
Why did I receive a letter from Renown’s ACO REACH?
CMS has determined you receive the majority of your care from providers who are part of the Renown’s Medicare REACH Program. We are required to send an annual notice to patients who CMS has aligned to the Renown’s Medicare REACH Program.
What is the difference between participating providers and preferred providers?
Participating providers are health care providers that are responsible for coordinating the whole person care of their patients. The ACO REACH Model ensures these providers are delivering the best value by achieving the highest quality outcomes for a cost appropriate for the patient’s needs.
Preferred providers are partners who support Renown’s Medicare REACH participating providers by contributing to the overall goal of better, more coordinated care for our Medicare beneficiaries. However, a preferred provider will not be responsible for coordinating the whole person care of those patients.
Can I continue to see other doctors or specialists?
Yes. As a Medicare Beneficiary, you are free to go to any doctor, hospital or other healthcare provider that accepts Original Medicare.
Renown’s Medicare REACH Program is governed by an Executive Team that provides clinical and administrative oversight for the organization’s participation in the ACO REACH Model. The Executive Team includes:
The amount of any Shared Savings or Shared Losses for any Performance Year. The Renown ACO REACH (formerly known as Renown DCE) is in its third year of operation.
Performance Year 2022 Shared Savings: $2,922,028.13
10% invested into infrastructure and administration: $298,166
90% distributed to Participants: $2,623,862.13
Shared Savings Investments
The proportion of Shared Savings invested in infrastructure, redesigned care processes, and other resources necessary to improve outcomes and reduce Medicare costs for patients. The Renown ACO REACH is in its second year of operation and does not have any Shared Savings Investment data to report.
Renown’s ACO REACH program is in its second year of operations. Quality performance data for our first program year will be released during the second half of 2023.
There are no joint ventures between or among Renown Direct Contracting entity, LLC and any of its Preferred Providers and Participating Providers.