CMS NEWS
FOR IMMEDIATE RELEASE
August 27, 2018
Contact: CMS Media Relations
(202) 690-6145 | CMS
Media Inquiries
ACOs taking risk in
innovative payment model generate savings for patients and taxpayers
Today, the Centers for Medicare & Medicaid Services (CMS) released
an evaluation report for the first performance year of the Innovation
Center’s Next Generation Accountable Care Organization (ACO) Model showing
promising early results. Results demonstrated the positive outcomes in
terms of quality and costs when providers are responsible for managing to a
budget. For the 2016 performance year, the Next Generation ACO Model
generated net savings to Medicare of approximately $62 million while maintaining
quality of care for beneficiaries. As part of CMS’s recent “Pathways to
Success” proposal, CMS proposed taking many principles from the Next
Generation ACO Model and adopting them more broadly for ACOs in the
Medicare Shared Savings Program.
“These results provide further evidence that ACOs succeed under
two-sided risk,” said CMS Administrator Seema Verma. “ACOs in the Next
Generation Model are being held accountable with strong financial
incentives and are provided with substantial flexibility and regulatory
relief. They are delivering value and providing quality care to
patients and taxpayers even in their first performance year, and we believe
that these results are achievable for other ACOs under similar incentives.”
ACOs are groups of health care providers that agree to take
responsibility for the total cost and quality of care for their patients.
In return, ACOs receive a portion of the savings they achieve. HHS
has issued waivers to provide the regulatory relief needed to innovate,
with more flexibility provided under increasing levels of risk.
After the release of the report, Administrator Verma spoke with the
Accountable Care Learning Collaborative—an organization that shares best
practices in accountable care with organizations in the healthcare industry—to
discuss the results of the report and CMS’s commitment to accelerating the
value-based transformation of America’s healthcare system, a top priority
of HHS Secretary Alex Azar.
The Next Generation ACO Model involves the highest levels of risk in any
ACO initiative offered by CMS. In exchange, ACOs in the Next Generation
Model have broader flexibility, including around the provision of
telehealth and the ability to offer incentives to beneficiaries for taking
steps to achieve and maintain good health. Nearly 1.5 million beneficiaries
in Fee-for Service Medicare are currently aligned to a Next Generation ACO.
These results reinforce CMS’ commitment to the principles outlined in
the Pathways to Success proposed
changes for the Medicare Shared Savings Program. The Administrator released
a Health Affairs blog
outlining the major provisions in that proposal.
In addition to releasing the evaluation report, for the first time, CMS
is releasing a “Findings at a Glance” document, which summarizes the key
findings in the evaluation report.
To view the Next Generation ACO Model’s first evaluation report, please
visit: https://innovation.cms.gov/Files/reports/nextgenaco-firstannrpt.pdf
To view the “Findings at a Glance” document, please visit: https://innovation.cms.gov/Files/reports/nextgenaco-fg-firstannrpt.pdf
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