- Providers interested in joining the Next Generation Accountable Care Organization (ACO) model in 2018 can now access the Request for Applications and Letter of Intent on the program’s portal, according to a recent CMS announcement.
The federal agency stated in December 2016 that it would reopen the 2018 Next Generation ACO model application process to allow more eligible clinicians to join an Advanced Alternative Payment Model under the Quality Payment Program.
In the same announcement, CMS also announced its intention to reopen the Comprehensive Primary Care Plus (CPC+) application process for 2018 participation. The CPC+ program will also qualify for Advanced Alternative Payment Model status.
By launching a second round of Next Generation ACO and CPC+ program applications, CMS intends to boost Advanced Alternative Payment Model participation. The federal agency expects at least 25 percent of eligible clinicians in the Quality Payment Program to be part of an Advanced Alternative Payment Model by 2018.
CMS also anticipates the second round of applications to boost Next Generation ACO program numbers. The federal agency added 28 new participants to the program for the 2017 performance year, bringing the program’s total number of ACOs to 45.
With the recent opening of the Next Generation ACO model’s Request for Applications portal, interested providers can access the letter of intent to apply. Providers must submit a letter to apply to the program, but it is non-binding, CMS noted.
Providers must also submit the letter of intent by May 4 to be considered for Next Generation ACO program participation in 2018.
CMS noted in December 2016 that the reopened 2018 application cycle will be the final round of Next Generation ACO applications. Any ACO selected to join the program will not be able to defer their participation, which was an option available in prior performance years.
For interested providers, CMS plans to host four open door forums. The federal agency announced the following forum schedule:
• Tuesday, March 14: Application Overview and Participating Provider Lists
• Tuesday, March 28: Benefit Enhancements Overview
• Tuesday, April 11: Overview of Population-Based Payments and All-Inclusive Population-Based Payments
• Tuesday, April 15: Deep Dive: Completing Your Next Generation ACO Model Participant List
The first open door forum will focus on Next Generation ACO applications and developing participating provider lists. CMS stated that the forum will function as an online webinar that will provide the basics about applying.
Providers can learn more about participating providers lists during the April 15 open door forum. At the online event, CMS will go over how to complete the participant list for application submission.
During the second open door forum, attendees will explore the three payment rule waivers offered under the Next Generation ACO model. The waivers, or benefit enhancements, include elimination of the three-day inpatient stay requirement for skilled nursing facility admission, regulatory restrictions on providing telehealth services in a beneficiary’s home, and limitations on post-discharge home visit services that need general supervision.
The third CMS forum will address the Next Generation ACO model’s alternative payment structure, including an overview on population-based payments.
The Next Generation ACO program builds on prior Medicare ACO model payment structures, such as the Medicare Shared Savings Program (MSSP). The newer ACO model offers providers higher financial risk levels for patient populations.
Unlike the previous Medicare ACO programs, Next Generation ACOs can take on full financial and performance accountability for their attributed beneficiaries. Rates for both shared savings and losses can be as high as 100 percent, but ACOs can also opt for lower rates of 80 percent.
Providers can register for each open door forum on the session’s webpage.