April 1, 2015

On March 10, 2015, the U.S. Department of Health and Human Services announced a new accountable care organization (“ACO”) initiative from the Centers for Medicare & Medicaid Services (“CMS”) Innovation Center – the Next Generation ACO Model (the “Next Generation Model”).

The Next Generation Model builds on experiences with the Pioneer ACO Model and the Medicare Shared Savings Program (“MSSP”), but is intended to set more predictable financial targets to enable providers and beneficiaries greater opportunities to coordinate and provide high quality care. The stated goal of the Next Generation Model is to “test whether strong financial incentives for ACOs, coupled with tools to support better patient engagement and care management, can improve health outcomes and lower expenditures for Original Medicare fee-for-service (“FFS”) beneficiaries.”

The announcement of the Next Generation Model follows a flurry of activity from CMS related to the MSSP, including its release of Notice of Proposed Rulemaking (and comment period) and issuance of additional guidance on certain requirements of the ACO Pre-Participation and Participation Waivers (summarized below). CMS has not indicated what, if any, impact the Next Generation Model will have on the MSSP or any of its other shared savings initiatives.

To view the full alert, click here.