In another step towards advancing models of care that reward value over volume, HHS announced the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery. A new initiative from CMS’s Innovation Center, the model is part of the agency’s plan to move an increasing percentage of Medicare of Medicare payments into models that support value-based care, and supports a number of tools including telehealth and post-discharge home services.
Building upon experience from the Pioneer ACO Model and the Medicare Shared Savings Program (MSSP), the Next Generation ACO Model is designed to set predictable financial targets, enable providers and beneficiaries greater opportunities to coordinate care, and attain the highest quality standards of care, according to HHS.
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 sharing, 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 management of care for their beneficiaries. These tools include the following:
- Rewards to beneficiaries for receiving their care from physicians and professionals participating in their ACOs;
- Coverage of skilled nursing care without prior hospitalization;
- Modifications to expand the coverage of telehealth and post-discharge home services to support coordinated care at home.
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.
CMS will accept ACOs into the Next Generation ACO Model through two rounds of applications in 2015 and 2016, with participation expected to last up to five years. Organizations interested in applying in 2015 must submit a Letter of Intent by May 1, 2015, and an application by June 1, 2015. Second round Letters of Intent and applications will be available in spring 2016.
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