“Next Generation” ACO Integrates Telehealth, Quality Metrics

June 8, 2015

The Department of Health and Human Services (HHS) announced in March that it will roll out a new accountable care organization (ACO) initiative called the Next Generation ACO Model, in January 2016. The new initiative improves on the existing Pioneer ACO Model and the Medicare Shared Savings Program by setting more predictable financial targets. This will give providers and beneficiaries to offer coordinated care and achieve the highest quality standards of care.

The goal of the new 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. A significant focus of the new model will be telehealth: participating organizations will be asked to provide access to both telehealth and home visits.

Medicare ACOs are comprised of groups of doctors, hospitals, and other health care providers and suppliers who come together voluntarily to provide coordinated, high-quality care at lower costs to their Original Medicare patients.
The Centers for Medicare and Medicaid Services (CMS) anticipates that 15 to 20 ACOs will participate in the new model. While it is unknown what kind of savings the new model will generate, savings from the Pioneer model could be a good indicator. In early May, it was revealed that the Pioneer ACO Model had generated approximately $384 million in Medicare savings in just two years. According to the CMS, the Next Generation ACO model could be a source of even more potential savings.

For other recent OneExchange posts on ACOs, see below:

Top Performing ACOs Save — and Share — Millions

New ACO Rule To Delay Penalties

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