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Deadline: June 1, 2015

Centers for Medicare and Medicaid Services: Next Generation Accountable Care Organization (ACO) Model

The U.S. Department of Health and Human Services (HHS) announced a new initiative from the Centers for Medicare & Medicaid Services’ Innovation Center (CMS Innovation Center): The Next Generation Accountable Care Organization (ACO) Model of payment and care delivery.

Building upon experience from the Pioneer ACO Model and the Medicare Shared Savings Program, the Next Generation ACO Model offers a new opportunity in accountable care—one that sets predictable financial targets, enables providers and beneficiaries greater opportunities to coordinate care, and aims to attain the highest quality standards of care.

The ACOs in the Next Generation ACO Model will take on greater performance risk than ACOs in current models, while also potentially sharing in a greater portion of savings. To support increased risk, ACOs will have a stable, predictable benchmark and flexible payment options that support ACO investments in care improvement infrastructure that provides high quality care to patients.

The new ACO model encourages greater coordination and closer care relationships between ACO providers and beneficiaries. ACOs will have a number of tools available to enhance the coordination of care for their beneficiaries. Beneficiaries will have opportunities to receive rewards for receiving care from ACOs. The Next Generation ACO Model also supports patient-centered care by providing the opportunity for beneficiaries to confirm a care relationship with ACO providers, and to communicate directly with their providers about their care preferences.

Amount: To be determined upon a performance agreement.

Eligibility: Next Generation ACOs may be formed by Medicare enrolled providers and/or suppliers structured as:

  • Physicians or other practitioners in group practice arrangements
  • Networks of individual practices of physicians or other practitioners
  • Hospitals employing physicians or other practitioners
  • Partnerships or joint venture arrangements between hospitals and physicians or other practitioners
  • Federally Qualified Health Centers (FQHCs)
  • Rural Health Clinics (RHCs)
  • Critical Access Hospitals (CAHs)

Link: http://innovation.cms.gov/initiatives/Next-Generation-ACO-Model/

Note: A letter of intent is due May 1, 2015 and the application is due June 1, 2015. There will be a second round in 2016.

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