Next Gen ACO Coalition Applauds CMS’ Continued Commitment to Advancing Performance-Based Risk Models

WASHINGTON, D.C. (Dec. 21, 2018) – The Centers for Medicare and Medicaid Services today reported more than $164 million in Medicare savings – with strong performance on quality metrics – for 44 Next Generation Accountable Care Organizations in 2017.  This builds on savings of $62 million across 18 Next Generation ACOs in 2016.

“We applaud CMS’s continued support for the move to two-sided models in traditional Medicare,” said Next Gen Coalition Executive Director Mara McDermott. “The strong performance of Next Gen ACOs, which accept the highest levels of performance-based risk, is proof positive that this program works and should be strengthened and continued to improve care delivery for patients.”

The full press release is available here.

Next Gen ACO Coalition Comments on Proposed Changes to Medicare Shared Savings Program

On October 16, 2018, The Next Gen Coalition submitted comments on proposed changes to the Medicare Shared Savings Program.  In our letter, we ask that CMS to make the Next Gen program a permanent offering in its Medicare risk portfolio.  We also call on the agency to continue to improve transparency and stability while incentivizing the move to performance-based risk.

The letter is available here.

Press Release: Next Gen ACO Coalition Formally Launches

WASHINGTON, D.C. (Sept. 20, 2018) – Twenty-nine Next Generation Accountable Care Organizations (ACOs) have formed a new coalition to advocate for the preservation and expansion of the Next Generation ACO program — a program which has benefited individuals, communities and federal payers since its establishment by the Center for Medicare and Medicaid Innovation in 2016.

The full press release is available here.

Twenty Six NGACOs Submit Letter to CMS

On September 5, 2018, 26 Next Gen ACOs sent a letter to CMS Administrator Seema Verma and Deputy Administrator for Innovation and Quality, Adam Boehler.  The letter asks that CMS eliminate the three percent ceiling on changes to risk scores, while maintaining the three percent floor; commit to a more predictable and stable payment methodology; and preserve and strengthen the Next Gen program.

The letter is available here.

CMS Releases Next Gen Model Evaluation

The Centers for Medicare & Medicaid Services (CMS) released the first annual report on the Next Generation Accountable Care Organization (ACO) model.  The report provides results from the 18 active Next Gens who participated beginning January 2016.  Key findings from the report showed that Next Gen ACOs reduced spending by approximately $100 million (a 1.7 percent reduction), or $62 million after adjusting for shared savings/shared losses.  The savings appear to be associated primarily with reductions in hospital and skilled nursing facility costs.  Notably, over half the model’s cost and utilization decline was generated by four of the 18 Next Gens.

The Next Gen ACO model was intended to test whether stronger financial incentives could improve care and reduce costs for traditional Medicare beneficiaries.  ACOs in the Next Gen model assume 80-100 percent two-sided risk and have additional flexibilities compared to other Medicare ACOs.  The ACO program is slated to run through December 31, 2020.  The Next Gen ACO model is one of a handful of qualifying Advanced Alternative Payment Models under Medicare’s Quality Payment Program.

The full report is available here.

The findings at a glance are available here.

The CMS press release is available here.

CMS Releases Proposed Rule Overhauling Medicare Shared Savings Program

The Centers for Medicare & Medicaid Services (CMS) released a long-awaited proposed rule that would revamp the Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs).  Among key changes, the rule reduces the amount of time ACOs can spend in upside-only arrangements (where they are eligible to share in savings but not at risk for repaying the government if they overspend their targets).  The rule also reduces the amount of savings an organization can share in when participating in an upside-only arrangement, and it proposes implementing several provisions of the Bipartisan Budget Act of 2018, including expanded use of beneficiary incentives, telehealth, and other flexibilities.

The proposed rule is available here.

The CMS fact sheet is available here.