A group of accountable care organizations (ACOs) have joined forces to advocate for the expansion of high-needs care models that improve outcomes and reduce costs for Medicare’s most vulnerable patients.

The newly-formed Complex Care Alliance has taken a stand, urging the Centers for Medicare and Medicaid Services (CMS) to extend crucial Medicare initiatives beyond their slated 2026 expiration.

On Tuesday, home-based primary care provider HarmonyCares announced its partnership with the Complex Care Alliance, expressing its support for the High-Needs ACO model, which helps provide care for Medicare’s sickest patients.

Established under the Global and Professional Direct Contracting model, now known as ACO Realizing Equity Access and Community Health (REACH), the High-Needs 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. Nearly 70% of these patients are dually eligible for both Medicare and Medicaid.

“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,” HarmonyCares CEO Matt Chance said in a press release. “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.”

HarmonyCares is a home-based primary care provider located in Troy, Michigan. The company offers services to individuals with complex health needs across 14 states. Its model also includes home health, hospice, palliative care, radiology and laboratory services.

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 approximately $143 million in 2023, resulting in a net savings rate of 13%.

HarmonyCares is the second-best-performing ACO REACH participant in the U.S., according to the company. It reports delivering $9.1 million in annual medical cost savings for approximately 700 aligned Medicare beneficiaries with complex illnesses in 2023, resulting in a net savings of 23%.

“CMS and the Innovation Center must take swift action to extend access to high-needs focused accountable care beyond 2026,” Mara McDermott, executive director of Accountable for Health, said in a statement. “Our members, including HarmonyCares, have proven that accountable care models deliver better care at reduced costs for this highly specialized population. We are proud to support them in launching the Complex Care Alliance to ensure vulnerable Medicare beneficiaries have access to high-quality, coordinated care.”

Accountable for Health is a national advocacy organization dedicated to accelerating the adoption of sustainable and effective accountable care, thereby improving healthcare quality and outcomes, and lowering costs.

The Complex Care Alliance aims to collaborate with CMS and the Innovation Center to ensure that Medicare beneficiaries maintain access to high-needs-focused accountable care that significantly enhances quality of life and lowers program spending.

The Complex Care Alliance’s 10 members are all participants in the High-Needs track of ACO REACH: Advanced Illness Partners, Bloom Healthcare, CareConnect MD, Curana Health, Ennoble Care, Essen Health Care, HarmonyCares, Intrinsia Health, Provider Partners Connect Care and Theoria Medical.

Along with Accountable for Health, the National Association of Accountable Care Organizations (NAACO), America’s Physician Groups (APG), the Coalition to Transform Advanced Care (C-TAC), and the American Academy for Home Care Medicine (AAHCM) have partnered with the newly-formed Complex Care Alliance to support its work.

“We are delighted to partner with our colleagues in the Complex Care Alliance,” Susan Dentzer, president and CEO of APG, said in a statement. “As an organization representing multiple ACO REACH participants, APG has been especially gratified to see such a strong performance among our High-Needs participants as they serve older adults with significant chronic or other serious illnesses and signs of frailty.”

Denzer added that these Medicare beneficiaries are frequently hospitalized if they don’t obtain preventive care. In the performance year 2023, the quality score for average days at home for these beneficiaries in High-Needs ACOs improved by more than five percentage points.