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Value-Based Care News

CMS Reopens 2018 Next Generation ACO Model Applications

CMS will now accept another round of Next Generation ACO model applications for 2018 participation, but providers must submit a LOI by May 4.

ACOs can submit a letter of intent to apply for the Next Generation ACO model by May 4, CMS announced

Source: Thinkstock

- Providers interested in participating in the Next Generation Accountable Care Organization (ACO) model in 2018 can now submit a letter of intent to CMS, according to the alternative payment model’s webpage.

The Next Generation ACO model is currently up to 45 total ACOs for 2017 participation after CMS recently added 28 new participants. But the federal agency plans to up participation in the next couple of years to increase the number of Advanced Alternative Payment Model clinicians.

CMS announced in December 2016 that it will re-open the 2018 application process for the risk-based ACO model to help more eligible clinicians in the Quality Payment Program join an Advanced Alternative Payment Model. Providers in an approved Alternative Payment Model in 2018 will be eligible to earn a five percent Medicare Part B incentive payment in 2020 depending on quality performance.

The Next Generation ACO model qualifies as an Advanced Alternative Payment Model because the model offers higher two-sided financial risk options compared to the Medicare Shared Savings Program and Pioneer ACO model. The model also explores how strong financial incentives can advance patient outcomes and reduce Medicare spending on fee-for-service beneficiaries.

In the same December 2016 announcement, the federal agency also reported that it will re-open the 2018 application process for the Comprehensive Primary Care Plus Program. The two-sided financial risk model will also qualify as an Advanced Alternative Payment Model in 2018.

By adding more participation opportunities for both risk-bearing alternative payment models, CMS intends for 25 percent of eligible clinicians in the Quality Payment Program to sufficiently participate in an approved Advanced Alternative Payment Model by 2018.

“We are excited to build on the progress of comprehensive primary care, the foundation of a better health system,” Patrick Conway, MD, CMS Acting Deputy Administrator, stated in a December press release. “Our Next Generation ACO model is the future of accountable care where providers take on full accountability for total cost of care and quality for a population of patients. These models allow doctors and other clinicians to practice the way they want to, including spending more time with patients, and provide coordinated, patient-centered care to all beneficiaries.”

To apply for 2018 Next Generation ACO model participation, interested providers must submit a letter of intent to apply by May 4. The letter can be found on the model’s webpage and must be returned to CMS in order to complete an application.

CMS also reported that the model’s application portal will open in March and all applications will be due in May.

With the new application opportunity for the Next Generation ACO model, though, providers should note that the re-opened application process will be the final round of Next Generation ACO applications. ACOs selected to participate will not be able to defer partaking in the model in 2018.

For providers seeking more information about the ACO model’s application process, CMS will hold two webinars that give a general overview of the model and letter of intent requirements on the following dates:

• Tuesday, Jan. 31, 2017

• Tuesday, Feb. 14, 2017 

The federal agency will also hold other webinars that focus on specific aspects of the Next Generation ACO model and its application process. The following webinars will be available:

• Tuesday, Feb. 28, 2017 – “Next Generation ACO Model Financial Methodology Overview”

• Tuesday, March 14, 2017 – “Overview of the Next Generation ACO Model Application and Participant List Process”

• Tuesday, March 28, 2017 – “Next Generation ACO Model Benefit Enhancements Overview”

• Tuesday, April 11, 2017 – “Overview of Population-Based Payments and All-Inclusive Population-Based Payments”

• Tuesday, April 15, 2017 – “Deep Dive: Completing Your Next Generation ACO Model Participant List”

Providers can register for the webinars on the Next Generation ACO model’s webpage.

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