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. Launched in 2016 and extended by a year to end at the end of 2021, Next Gen builds off the Pioneer ACO Model, which started in 2012.The Direct Contracting Model is built off Next Gen ACOs.

Overview

• CMS Next Generation ACO webpage and federal regulations governing the MSSP
  
  
• CMS fact sheet on Next Gen ACOs
  
  
• CMS-CMMI announces the first class of Next Generation ACOs 
• NAACOS press release celebrating the Next Gen ACO Model 

NAACOS Member Resources

• NAACOS chart comparing Direct Contracting and other high-risk ACOS
  
  
• 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 
  
  
• CMS overview of benchmarking methodologies for the 2019 and 2020 
  
  
• NAACOS ACO Comparison Chart updated to reflect the new Pathways structure and old MSSP structure
  
  
• NAACOS partnered with Wilems Resource Group to offer Next Gen ACOs a Compliance Manual customizable to meet your individual needs. 
  
  
• This webinar explains how ACOs can use the NAACOS Compliance Manuals
  
  
• 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! 

• 2020 Quality Amendment and 2021 Extension Amendments 
  
  
• CMS presentation on financial methodology updates in response to COVID-19>
  
  
• CMS Innovation Center announces model changes because of COVID-19
  
  

• HHS Inspector General extends certain fraud and abuse waivers for Next Gen ACOs

• CMS’s summary on 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  quality measure set and quality withhold
• Measure specifications and benchmarks for 2020/2021

• CMS MLN Article on Next Gen ACO 2019 Benefit Enhancements
  • Clarification on submitting claims for the Post Discharge Home Visit Waiver 

• Next Gen ACO Policy and Operating Procedures: Adding and terminating TINs and Preferred Providers during the performance year 

• Next Generation ACO Model Sample Participation Agreement 

• CMS resource on Population Based Payment implementation 

News and Advocacy

• NAACOS letter to the Innovation Center outlines steps to promote value-based care and provides detailed program recommendations"
  
  

• NAACOS joins 13 other groups in a letter urging HHS to extend the Next Generation ACO Model through 2022 and create a permanent full-risk ACO option based on Next Gen

• NAACOS writes HHS Secretary Becerra on policy priorities for the new administration
  
  
• Highlights of ACO results from 2019 and overall savings since 2012
  
  
• Letter from NAACOS urges CMS to not implement unilateral changes to the Next Gen trend for 2020
• CMS letter responding to NAACOS advocacy on 2020 changes to Next Gen trend
  
  
• NAACOS letter supports Next Gen extension and asks for further program modifications to protect ACOs in response to COVID-19
  
  
• NAACOS statement on CMMI’s extension of the Next Gen ACO Model
  
  
• NAACOS urges swift action to extend the Next Generation ACO Model and announce plans for the future of the Direct Contracting Model
  
  
• Next Gen ACOs generated $406 million in savings to Medicare in 2018, according to CMS performance data
• CMS also released the second evaluation report
  
  
• NAACOS Statement on New Payment Models and Goals to Move to Value-Based Care
  
  
• Nine groups urge CMS to pay Advanced APM bonuses
  
  
• NAACOS submits feedback on new Geographic and Professional and Global Options of Direct Contracting Models from the CMS Innovation Center
  
  
• NAACOS released a statement welcoming more options for value-based payment arrangements in the form of Direct Contracting and Primary Care First
  
  

• Ten provider organizations, including NAACOS, ask the Next Generation ACO Model be made a permanent Medicare program”

• NAACOS-led Letter Urges HHS to Certify Next Generation ACO Model
  
  
• A press release was also issued on the letter
  
  
• NAACOS calls for greater transparency in Innovation Center’s work
  
  
  • Press release on the letter to CMS
    
    
• 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