CMS announces next generation of ACO model

The Centers for Medicare & Medicaid this week launched a new Accountable Care Organization model that the agency says will “reward value over volume in care delivery.”

The Next Generation ACO Model, as it has been named, is an initiative from CMS’ Innovation Center.

ACOs are groups of providers that contract with the Medicare program under one entity to offer services with little or no co-pay. Those ACO’s in the new model will take on a greater performance risk than ACOs in existing models, but potentially share in a larger portion of savings.

The new model builds on experience gained from the Pioneer ACO model, as well as Medicare’s Shared Savings Program.

“This ACO model responds to stakeholder requests for the next stage of the ACO model that enables greater engagement of beneficiaries, a more predictable, prospective financial model, and the flexibility to utilize additional tools to coordinate care for beneficiaries,” Patrick Conway, deputy administrator for Innovation and Quality and chief medical officer for CMS, wrote in a blog post.

CMS expects approximately 15 to 20 ACOs to participate in the Next Generation ACO Model with representation from a variety of provider organization types and geographic regions. The model will consist of three initial performance years and two optional one-year extensions.

CMS will accept ACOs into the Next Generation ACO Model through two rounds of applications this year and next, with participation expected to last up to five years. Organizations interested in applying in 2015 must submit a Letter of Intent by May 1, 2015, and an application by June 1, 2015. Second round Letters of Intent and applications will be available in spring 2016.

Applications can be found here.

Posted in

The Health Law Offices of Anthony C. Vitale