Direct Contracting: Finding Meaning in the Acronyms

Corey Redding – Executive Director, CareAllies Accountable Care Solutions, LLC

GPDC, DCE, and ACO REACH. These acronyms are all associated with evolving demonstration models being assessed by the Center for Medicare & Medicaid Innovation (the CMS Innovation Center). They can seem like jumbled letters in an alphabet soup of Medicare programs.

Let’s take a look at what these acronyms stand for and, more importantly, what they mean for providers now and in the future.

Understanding the acronyms

To start, here is what each acronym above means and how they relate to one another:

• GPDC stands for the Global and Professional Direct Contracting It is a voluntary Accountable Care Organization (ACO) model that started on October 1, 2020, and will last until December 31, 2022, when it will be replaced by ACO REACH. In essence, GPDC aims to bring elements of value-based care to Original Medicare beneficiaries.

Medicare beneficiaries keep all the benefits of Original Medicare — including the ability to see any provider they wish. However, they might receive added benefits (such as telehealth) if they choose to see a provider who participates in the GPDC Model. Providers who decide to join in GPDC have two risk-sharing options to select from, as well as reduced administrative burdens.

• DCE is an abbreviation that means “Direct Contracting Entity.” This term is simply another way to refer to the ACOs involved in GPDC. For example, CareAllies’ Accountable Care Solutions is a DCE. The providers within a DCE operate under a shared governance structure and work toward high-quality, patient-centered care.

The term DCE will be replaced when the GPDC Model is replaced later this year. Entities that participate in the new model - ACO REACH - will be called REACH ACOs.

• ACO REACH is short for Accountable Care Organization Realizing Equity, Access, and Community Health. As of January 1, 2023, ACO REACH will replace the GPDC Model, building upon the feedback and lessons learned from GPDC. Organizations that currently participate in GPDC don’t have to reapply for the ACO REACH Model, as long as they maintain a strong compliance record and agree to the new Model’s requirements.

ACO REACH will focus even more on enabling health equity for underserved populations, ensuring provider and beneficiary representation on governing boards, and promoting transparency. As with GPDC, the Medicare beneficiaries in ACO REACH will keep all their Original Medicare benefits and may have access to additional benefits such as telehealth, care coordination, and home visits after a hospital stay.

Understanding the impact

For more than a decade, the CMS Innovation Center has worked to transform health care from fee-for-service reimbursement to more equitable and value-based care delivery and payment models. GPDC and ACO REACH are just two of the newest refinements in a progression that the Innovation Center is committed to continuing over the long term to empower patients, reduce provider burdens, and transform risk-sharing arrangements.

CareAllies is excited to continue being a part of this momentous journey. Demonstration models like GPDC and ACO REACH promise to move the industry closer to a more flexible and collaborative way to create healthier communities and care for our most vulnerable patients. To be sure, understanding these programs sometimes requires us to slog through a bowl of alphabet soup. But over time, all those nuanced acronyms are sure to drive more effective and meaningful health care for everyone.