Next Generation ACOs: Most participants were previously in Pioneer and MSSP models

Advanced accountable care model requires greater risk for potential of greater reward

Fifteen of the 21 participants in Medicare's new Next Generation accountable care organization model--the most aggressive ACO option to date--are made up of previous participants of the Pioneer and Medicare Shared Savings Program.

[RELATED: CMS unveils first group of Next Generation ACOs]

Eight of the participants were formerly part of the Pioneer model, where organizations accepted two-sided risk for penalties and bonuses. Seven previously belonged to the shared savings program.

The breakdown of the newly announced participants shows that the model appeals to the most sophisticated and experienced of early population health managers, said Rob Lazerow, practice manager, research and insights, at The Advisory Board Company, which works with 230,000 leaders at 5,200 member organizations to improve performance, during an exclusive interview with FierceHealthcare.

"For the organizations and providers that have had success as a Pioneer ACO or in the Medicare Shared Savings Program, the Next Generation is an attractive evolution on the journey to population health," he said.

That was the reason the more advanced model made sense for Accountable Care Coalition of Southeast Texas, an ACO formed in partnership with Collaborative Health Services, a Universal American Corp. and primary care physicians, Richard Barasch, chairman and CEO of Universal American, told FierceHealthcare. The 118 providers in the ACO will serve more than 12,500 Medicare beneficiaries.

The physicians who are part of the ACO have had success coordinating care and lowering costs through value-based programs such as Medicare's shared savings program and Medicare Advantage plans, Barasch said. These same physicians work with TexanPlus, Universal American's four-star Medicare Advantage plan in Southeast Texas.

Barasch said that the model shows great potential for this particular group of primary care physicians, which has already had success with value-based care. Although many organizations have been hesitant to implement a value-based care model, Barasch said the success the group has had indicates it is possible, although he warned results won't show up immediately.

"It takes time and patience. There is no magic bullet," he said. "It's important for folks to understand this is change, and change not simple. Doctors and systems have to be prepared to work, And once you do the work, the rewards will be better care and lower costs."