NextGen ACO Model Extended

The NGACO model has been extended through December 2021! CMS and the Innovation Center have recognized the important contributions Next Gen ACOs are making to their patient populations, communities, and the move to performance-based risk.

The Centers for Medicare & Medicaid Services (CMS) Innovation Center is providing new flexibilities and adjustments to current and future Innovation Center models in response to the COVID-19 Public Health Emergency (PHE). CMS has heard our feedback through letters, comments and requests for flexibilities. With these considerations in mind, they did a comprehensive review of their models, and are incorporating appropriate adjustments and flexibilities.

Center Model

Financial Methodology Changes

Quality Reporting Changes

Model Timeline Changes

Next Generation ACO (NGACO)

• Reduce 2020 downside risk by reducing shared losses by proportion of months during the PHE.

• Cap NGACOs’ gross savings upside potential at 5% gross savings

• Remove episodes of care for treatment of COVID-19

• Use retrospective regional trend, rather than prospective, for 2020

• Remove 2020 financial guarantee requirement

• 2019 Web Interface quality measure reporting deadline extended from March 31, 2020 to April 30, 2020

• 2019 quality audit canceled

• Continue to monitor impact on 2020 quality reporting

• Extend model through December 2021

Categories: MWMD Newsletter