CMS launches 'Next Generation' ACO model
- The Centers for Medicare and Medicaid Services on Tuesday launched the "Next Generation Accountable Care Organization" model, which will provide "more predictable financial targets" and more care coordination and beneficiary engagement opportunities, according to Patrick Conway, MD, chief medical officer and deputy administrator for innovation and quality at CMS.
- The new model will have four payment systems and two risk tracks, including one that is "essentially near 100% risk."
- The agency expects between 15 to 20 ACOs to take advantage of the model—including some migrants from the Pioneer program—from across provider types and geographical locations. ACOs will need 10,000 aligned beneficiaries, 7,500 of which have to be from rural areas, in order to qualify for the program.
The goal, according to Conway, is to test whether stronger financial incentives can improve outcomes and cut costs for Medicare beneficiaries. "To support increased risk, ACOs will have a stable, predictable benchmark and flexible payment options that support ACO investments in care improvement infrastructure to provide high quality care to patients," Conway wrote on the agency blog.
This is obviously the agency's response to claims that MSSP and other CMS accountable care models force providers to compete against their own best performance—something hospitals haven't been shy about criticizing.
Want to read more? You may enjoy this feature on Rick Gilfillan on payment reform and the most under-reported story in healthcare.
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