CVS directing its Chicago ACO Reach patients to RUSH for primary, specialty follow-up

CVS Health’s Accountable Care Organization division has cut a deal with Chicago’s Rush University System for Health (RUSH) that allows Medicare patients seeking care at certain MinuteClinic locations to receive follow-up services from the academic health system.

The arrangement will be based on the Center for Medicare and Medicaid Innovation's (CMMI's) Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) model, the overhauled Direct Contracting Model that entered its first performance period at the top of 2023.

The ACO REACH model lets providers take on more financial risk for meeting a quality and spending benchmark that is adjusted based on local care disparities. CVS ACO is among the 132 ACOs participating this year, according to CMMI.

CVS’ MinuteClinics provide same-day screening and treatment for common conditions, either as a walk-in service or virtually in line with the company’s “omnichannel care model.”

Going forward, Medicare patients seeking services at the retail clinics in Chicago and Evanston will have RUSH as an option for their follow-up primary and specialty care needs. The organizations also said that customized support such as home-based care, transportation support and cost-sharing for copays will also be offered to those in need.

“As part of CVS Health’s care delivery strategy, we are engaging our assets on behalf of this ACO REACH population to help drive high-quality outcomes, promote health equity, and bring health care costs down,” Mohamed Diab, CEO of CVS ACO, said in the announcement. “Our strategic alignment with RUSH has the potential to help improve longitudinal care for their Medicare population of 35,000 beneficiaries.”

The arrangement cements RUSH as the only Chicago-area academic medical center participating in CVS’ first ACO REACH program, per the announcement.

The nonprofit system is comprised of its flagship RUSH University Medical Center, RUSH Copley Medical Center, RUSH Oak Park Hospital, RUSH University and a network of more than 140 physician practices. The organization is no stranger to value-based care, having previously participated in the Medicare Shared Savings Program.

“This provides another option for patients at a time when access to high-quality health care is more important than ever,” RUSH President and CEO Omar Lateef, M.D., said in a statement. “It will help strengthen care coordination for patients while enabling them to receive services convenient to where they live and work.”

Both organizations said their participation in the ACO REACH model advances their ongoing commitments to addressing health disparities and improving access to care.

“In every part of our business at CVS Health, we ensure that culturally competent care is integrated into the design and development of new population health initiatives, products and services,” Diab said. “Our new ACO REACH work and collaboration with RUSH is another example of our focus on improving health equity.”