The Centers for Medicare & Medicaid Services’ (CMS’) most advanced ACO (accountable care organization) program, the Next Generation ACO model, generated $164 million in net savings in 2017.
CMS released the 2017 Next Gen ACO results on Dec. 21, the same day the agency published a final rule that overhauls another federal ACO model, the Medicare Shared Savings (MSSP) program.
There are currently 51 ACO participants in the Next Gen model, according to CMS, though for the 2017 program year, there were 44 organizations involved serving 1.2 million Medicare patients. As CMS explained on its website when it launched this ACO model in January 2016, “Building up on experience from the Pioneer ACO Model and Medicare Shared Savings Program, Next Generation ACO Model offers a new opportunity in accountable care—one that sets predictable financial targets, enables providers and beneficiaries greater opportunities to coordinate care, and aims to attain the highest quality standards of care.”
Next Gen model participants have the opportunity to take on higher levels of financial risk—they can either choose a 100 percent full-risk option or an 80 percent shared risk option—than ACOs in other current initiatives. While they are at greater financial risk, they also have a greater opportunity to share in more of the model’s savings through better care coordination and care management.
In addition to the $164 million in net savings, the Next Generation program achieved $337 million in gross savings, including discounts, to Medicare in 2017, according to a NAACOS (National Association of ACOs) review of the data.
In 2016, the first year of the Next Gen program, there were 18 ACO participants, of which 11 (61 percent) earned shared savings. The first cohort of this model’s ACOs generated net savings to Medicare of approximately $62 million while maintaining quality of care for beneficiaries for the 2016 performance year. In 2017, the program’s second year, 32 of 44 ACOs earned shared savings payments.
“These results are another important data point proving the ACO model is hitting its goals of improving the quality of care and lowering health costs,” NAACOS CEO Clif Gaus said in a statement. “The Next Generation Model comprises some of the most advanced ACOs in the country, leveraging sophisticated care coordination techniques and cutting-edge technology.”
The Next Gen program is slated to run through 2020, and NAACOS has “urged the Center for Medicare and Medicaid Innovation (CMMI) to move forward with developing and releasing more details on an advanced ACO model that will replace the Next Gen Model and build on its success.”