In a new ACO model that the Centers for Medicare & Medicaid launched Tuesday, providers could take on more financial risk--and reap greater financial rewards.
The "Next Generation Accountable Care Organization" model will give participants more predictable financial targets and greater opportunities to coordinate care and engage beneficiaries, Patrick Conway, M.D., chief medical officer and deputy administrator for innovation and quality at CMS, said during a press call Tuesday afternoon.
The goal is to determine whether stronger financial incentives for ACOs can improve health outcomes and reduce expenses of Medicare patients, he said.
The model offers "a new opportunity in accountable care--one that sets more predictable financial targets, enables providers and beneficiaries greater opportunities to coordinate care and aims to attain the highest quality of care," Conway wrote in a CMS blog post.
Participant ACOs will have more tools to manage patient care, he said, including additional coverage of telehealth and post-discharge home services as well as reward payments to beneficiaries for receiving care from ACOs.
The ACO model will have two risk tracks--one of which is "essentially near 100 percent risk," Conway said on the call--and four payment systems.
Conway said he expects the model will attract between 15 and 20 ACOs with representation from a variety of provider organization types and geographical regions. The minimum number of aligned beneficiaries is 10,000, with 7,500 of them from rural areas.
He added that he expects some Pioneer ACOs will migrate to the new program, while other participants might be "newbies, if you will."
"This model is part of our larger effort to set clear, measurable goals and a timeline to move the Medicare program--and the healthcare system at large--toward paying providers based on the quality, rather than the quantity of care they give patients," Department of Health and Human Services Secretary Sylvia M. Burwell said in an announcement.
Ilene MacDonald contributed to this report.