Next Gen ACO Model

Background

The Next Generation ACO Model offers ACOs with sufficient experience in advancing population health higher rewards and risk than the Medicare Shared Savings Program. The Next Gen model aims to transition providers from fee-for-service to capitation and allows greater flexibility for care coordination. Launching in 2016 and set to end at the end of 2020, Next Gen builds off the Pioneer ACO Model, which started in 2012.

Overview

NAACOS Member Resources

  • Timeline Reviewing Key Dates for ACOs in 2019

  • NAACOS chart of CMS Innovation Center models and their overlap with ACOs

  • NAACOS webinar “Understanding Next Gen Risk Adjustment and How to Maximize ACO Performance”

  • NAACOS summary of the 2019/2020 Next Generation Model Methodology changes with comparison to the current methodology 

  • NAACOS ACO Comparison Chart updated for 2019 to reflect the new Pathways structure and old MSSP structure

  • NAACOS webinar “Next Generation ACO Model: Lessons Learned and Planning for Participation” 

  • NAACOS members have access to our exclusive listserv of member ACOs. This tool allows you to send messages and ask questions through a single email to distribute messages to all of the members subscribing to the list! 
CMS Resources on Program Changes 
  • HHS Inspector General extends certain fraud and abuse waivers for Next Gen ACOs

  • CMS’s summary of 2019 benefit enhancements
    • FAQs on telehealth waiver

    • FAQs on home visit waivers

    • FAQs on SNF three-day waiver

    • FAQs on cost-sharing support

    • FAQs on “gift card” benefit enhancement

    • FAQs on voluntary alignment 
  • CMS’s summary of the 2019 quality measure set and quality withhold
    • 2019 quality measures list 
  • CMS MLN Article on Next Gen ACO 2019 Benefit Enhancements
    • Clarification on submitting claims for the Post Discharge Home Visit Waiver 
  • CMS overview of benchmarking methodologies for the 2019 and 2020 
  • Next Generation ACO Model Sample Participation Agreement 
  • CMS resource on Population Based Payment implementation 

News and Advocacy

  • NAACOS calls for greater transparency in Innovation Center’s work
  • Next Gen ACOs generated $337 million in gross savings including discounts to Medicare in 2017, according to CMS performance data
  • Innovation Center analysis shows Next Generation ACOs curbed Medicare spending by more than 1 percent in its first year. See the NAACOS statement on the release here
  • NAACOS resource provides highlights of the 2018 Medicare ACO class and shows ACO growth over time 
  • NAACOS submitted comments on the future of the Innovation Center 
  • NAACOS submitted comments in response to CMS’s Request for Information on Direct Provider Contracting models 
  • CMMI announces 58 ACOs participating in the Next Generation ACO Model in 2018, list available here.
  • NAACOS press release welcomes and congratulates 2018 Next Gen ACO class  
  • Highlights of the 2016 Medicare ACO performance results
    • NAACOS press release highlights the success of 2016 Next Gen ACOs 

  • NAACOS provides detailed recommendations to CMS on how to enhance program reports and data files for Next Gen  ACOs