This month, the Centers for Medicare & Medicaid Services (CMS) announced the beginning of the second application cycle for its Next Generation ACO Model (Next Gen Model). We discussed the goals of the Next Gen Model and how it compares to the Medicare Shared Savings Program and Pioneer ACO models in this post from last year.
The Next Gen Model, along with other value-based payment initiatives being run by CMS, advances the goals of the Affordable Care Act by moving providers away from fee-for-service reimbursement models. Since CMS began implementing its ACO-based initiatives in 2012, over 477 ACOs nationwide have partnered with the agency to test the theory that coordinated care provide higher quality at a lower cost for beneficiaries.
Twenty-one ACOs are currently participating in the Next Gen Model – more than the 15-20 CMS anticipated accepting. Like last year, the Centers for Medicare & Medicaid Innovation (“CMMI”) is holding a series of Open Door Forums to explain key aspects of the Next Gen Model on the following dates:
- 2017 Letter of Intent Overview (March 22, 2016)
- 2017 Application Overview (March 29, 2016)
- 2017 Financial Methodology (April 5, 2016)
- 2017 Participating Provider List (April 12, 2016)
- 2017 Benefit Enhancements (April 19, 2016)
ACOs (including MSSP participants and Pioneer ACOs) have until May 2, 2015 to submit a Letter of Intent (LOI) using CMS’s designated portal. Applicants must electronically complete the narrative portion of the Next Gen Model application by May 25, 2016 and submit their participating provider lists and geographic service areas no later than June 3, 2016.
This will be the final year for ACOs to participate in the Next Gen Model. It is hard to predict what will happen to the Medicare payment reforms tested in the Next Gen Model and other ACA-related programs as the United States enters into a new administration after the 2016 elections, but CMS is currently staying the course to reduce health care costs while improving quality.