On January 11, the Centers for Medicare & Medicaid Services
(CMS) published the list of 21 ACOs approved
under its Next Generation Accountable Care Organization (NGACO)
Model, including several ACOs that transferred from the Pioneer
Model or the Medicare Shared Savings Program.
The NGACO Model gives participants more flexibility for financial
risk and shared savings with two risk options available: one in
which providers can share in 80% of the savings or losses based on
their quality and cost-control performance, and one that involves
100% financial risk for medical costs. Savings are determined by a
formula that doesn't solely rely on an ACO's past
performance benchmark data. In addition, payment for services in
the NGACO Model can be either traditional Medicare fee-for-service
or a value-based payment, and a capitation option will be available
starting in 2017.
The NGACO Model includes provisions for expanded services, such as
home visits and remote visits using technology. CMS noted that the
number of Medicare ACOs nationwide has grown to over 477, currently
serving nearly 8.9 million beneficiaries in the four different
models (Pioneer, Shared Savings, Next Generation, and Comprehensive
End-Stage Renal Disease Care), since the initial Pioneer Model
began in 2012.
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