Twenty-one organizations will become the first to join Medicare's new accountable care organization (ACO) model, the Next Generation, taking on greater financial risk but potentially reaping greater financial rewards.
Unlike other Medicare ACOs, the Next Generation model includes a prospective set benchmark, allows beneficiaries to choose to be aligned to the ACO and tests beneficiary incentives for seeking care at Next Generation providers, including increased availability of telehealth and care coordination services, according to an announcement.
Next Generation ACO participants can take up to 100 percent risk, according to the announcement. But they also have an opportunity to share more savings through better care coordination and case managements. In addition, they can also receive their budgets in advance of a performance year, to plan and manage care around these financial targets. In addition, CMS said they can select from flexible payment options, such as infrastructure payments that support ACO investments in care.
Participants include:
- Accountable Care Coalition of Southeast Texas Inc.
- Baroma Accountable Care, LLC
- Beacon Health, LLC
- Bellin Health DBA Physician Partners, Ltd. (PPL)
- Cornerstone Health Enablement Strategic Solutions, LLC (CHESS)
- Deaconess Care Integration
- Henry Ford Physician Accountable Care Organization
- Iowa Health Accountable Care
- MemorialCare Regional ACO, LLC
- Optum Accountable Care Organization
- OSF Healthcare System
- Park Nicollet Health Services
- Pioneer Valley Accountable Care, LLC
- Prospect ACO CA, LLC
- Regal Medical Group, Inc.
- River Health ACO, LLC
- Steward Integrated Care Network, Inc.
- ThedaCare ACO LLC
- Triad HealthCare Network, LLC
- Trinity Health ACO Inc.
- WakeMed Key Community Care, LLC
In total, the Centers for Medicare & Medicaid Services will have 121 new participants in its ACO models, including the Shared Savings Program, Pioneer ACO model and the Comprehensive ESRD Care Model.
To learn more:
- here is the announcement