On Monday, CMS announced that 21 organizations — including three in California — initially will participate in its Next Generation Accountable Care Organization Model, MedPage Today reports (Frieden, MedPage Today, 1/11).
Background
CMS unveiled the Next Generation ACO model in March 2015. The program uses a combination of fee-for-service and capitated payments. It creates four payment systems and two risk tracks for its participants, including one with almost full risk (California Healthline, 3/11/15).
In addition to placing more risk on the organizations, the model also will allow providers more freedom to use telemedicine and home visits (California Healthline, 11/6/15).
Patients under the new model will be able to voluntarily sign up to participate in the ACOs. In exchange, they will pay reduced or no copayments for certain services, such as primary care visits (California Healthline, 3/11/15).
CMS Announces New Participants Across Various ACO Programs
According to the AP/Sacramento Bee, CMS announced a total of 121 new participants across its various ACO programs, including:
- The 21 Next Generation ACOs, which will care for 650,000 Medicare beneficiaries at the program’s start (Alonso-Zaldivar, AP/Sacramento Bee, 1/11);
- 100 new ACOs in the Medicare Shared Savings Program; and
- 147 renewing ACOs in MSSP (CMS release [1], 1/11).
The new Next Generation ACO participants include three California-based organizations:
- MemorialCare Regional ACO, in Fountain Valley;
- Prospect ACO CA, in Los Angeles; and
- Regal Medical Group, in Northridge (CMS release [2], 1/11).
In addition, CMS announced that 41 MSSP ACOs have joined CMS’ ACO Investment Model, which offers “pre-paid shared savings to encourage new ACOs to form in rural and underserved areas and to encourage current Shared Savings Program ACOs to transition to performance-based risk arrangement” (MedPage Today, 1/11).
They agency’s four ACO programs now include 477 organizations, which will provide care for a total of about 8.9 million Medicare beneficiaries (Herman, Modern Healthcare, 1/11).
According to CMS, a second round of applications for the Next Generation Model will open in the spring (CMS release [2], 1/11).