Menu Close

CMS Announces Next Generation ACOs for 2016

Posted in Accountable Care Organizations, Affordable Care Act, Home Healthcare, Hospitals and Institutions, Legislation and Public Policy, Medicare and Medicaid, Reimbursement Matters

On January 11, the Centers for Medicare & Medicaid Services (CMS) published the list of 21 ACOs approved under its Next Generation Accountable Care Organization (NGACO) Model, including several ACOs that transferred from the Pioneer Model or the Medicare Shared Savings Program.

The NGACO Model gives participants more flexibility for financial risk and shared savings with two risk options available: one in which providers can share in 80% of the savings or losses based on their quality and cost-control performance, and one that involves 100% financial risk for medical costs. Savings are determined by a formula that doesn’t solely rely on an ACO’s past performance benchmark data. In addition, payment for services in the NGACO Model can be either traditional Medicare fee-for-service or a value-based payment, and a capitation option will be available starting in 2017.

The NGACO Model includes provisions for expanded services, such as home visits and remote visits using technology. CMS noted that the number of Medicare ACOs nationwide has grown to over 477, currently serving nearly 8.9 million beneficiaries in the four different models (Pioneer, Shared Savings, Next Generation, and Comprehensive End-Stage Renal Disease Care), since the initial Pioneer Model began in 2012.

Leave a Reply

Your email address will not be published. Required fields are marked *