Deadline approaches for 2017 enrollment in Next Gen ACO model from CMS

For Centers Medicare and Medicaid Services (CMS), the future is almost here for its Next Generation accountable care organization (ACO) model. ACOs that wish to be admitted into the Next Gen model for 2017 must submit a non-binding letter of intent by May 2 and complete the application by May 25.

The Next Generation model is the newest ACO program from CMS, available along with models such as the Pioneer ACO and Medicare Shared Savings Program (MSSP). Next Generation ACOs will be able to assume higher levels of financial risk than previous incarnations. The model includes prospectively set benchmarks, allows beneficiaries to choose to be aligned with the ACO, tests incentives for beneficiaries to see care and increases the availability of telehealth and care coordination services.

Next Gen ACOs will receive budgets before the year, allowing them to plan accordingly to reach their targets. The previous models from CMS were retrospective, meaning clinicians only found out which individuals they were financially responsible for after the year’s end.

According to CMS, the Next Generation model is designed to:

• Protect the freedom of Medicare beneficiaries to seek the services and providers of their choice;
• Engage beneficiaries in their care through benefit enhancements designed to improve the patient experience and reward seeking care from ACOs;
• Create a financial model with long-term sustainability;
• Utilize a prospective benchmark that rewards quality and efficiency and transitions away from an ACO’s recent expenditures when setting and updating the benchmark;
• Mitigate fluctuations in aligned beneficiary populations and respect beneficiary preferences by supplementing a prospective claims-based alignment process with a voluntary process; and
• Smooth ACO cash flow and support investment to improve care through alternative payment mechanisms.