Next Generation ACOs: Most participants were previously in Pioneer and MSSP models

The Next Generation model is the latest addition to CMS’ ACO initiatives to improve the care patients receive in the U.S. healthcare system while lowering costs.

Shared Savings Program ACOs also outperformed group practices reporting quality on 18 out of 22 measures, CMS said.

Fifteen of the 21 participants in Medicare’s new Next Generation accountable care organization model-the most aggressive ACO option to date-are made up of previous participants of the Pioneer and Medicare Shared Savings Program. The initiative is expected to result in better health, better care and lower costs and to impact individuals as well as whole communities. This model “will provide pre-paid shared savings to encourage new ACOs to form in rural and underserved areas and to encourage current Shared Savings Program ACOs to transition to performance-based risk arrangement”, the press release explained.

On Monday, CMS announced that 21 organizations – including three in California – initially will participate in its Next Generation Accountable Care Organization Model, MedPage Today reports (Frieden, MedPage Today, 1/11). Medical office staff will be trained in population health management, including care coordination, quality improvement, annual wellness visits, and patient satisfaction, and can begin billing for these professional services. “These new initiatives place patients at the center of a coordinated care delivery system and give providers the tools to achieve better outcomes”, said Patrick Conway, MD, CMS chief medical officer, in the email. Although many organizations have been hesitant to implement a value-based care model, Barasch said the success the group has had indicates it is possible, although he warned results won’t show up immediately. But under President Obama’s health care law, the program is trying to shift to rewarding quality over sheer volume of services. “This initiative is focused on improving continuity and coordination of care consistent with our goals of assuring improved patient experience and better outcomes of care”.

“Since the start of the ACO program in early 2012, thousands of health care providers have signed on to participate”.

Thirty-nine Shared Savings Program ACOs will also participate in the ACO Investment Model (AIM).

The NGACO Model is tied to the Department of Health and Human Services’ goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to alternative payment models, such as ACOs, by the end of 2016, and tying 50 percent of payments to these models by the end of 2018.

The Center for Medicare and Medicaid Innovation (CMS Innovation Center) https://innovation.cms.gov/index.html was created by the Affordable Care Act to test innovative payment and service delivery models to reduce program expenditures while preserving or enhancing the quality of care for Medicare, Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries. Mercy is part of Trinity Health, a national tax-exempt system with operations in 20 states.

According to its new website, Trinity Health ACO is a collaboration of Lourdes Health Network, Affinia Health Network, Health Collaborative of Central Ohio, Loyola Physician Partners and Summit Medical Group serving patients in Michigan, Ohio, Illinois and New Jersey.