hospital administrators working on financial charts

July 24, 2019 – CMS has released three new case studies describing innovative programs from Medicare Accountable Care Organizations (ACOs). The case studies feature ACO initiatives related to:

  • promoting staff development through leadership academies,
  • conducting home visits, and
  • engaging providers.

The case studies highlight ACOs participating in the Next Generation ACO Model and the Medicare Shared Savings Program. Each case study includes detailed results and describes lessons learned by the ACO during implementation. By sharing the stories, CMS hopes to help current and future Medicare ACOs, and other providers and entities, find new ways to make care better, people healthier, and spending smarter.

For more information on these case studies, and to view past case studies and the ACO Toolkit on Care Coordination, please visit the ACO General Information web page.

doctor working on a patient chart on an ipad

April 12, 2019 – CMS has released a public ACO Care Coordination Toolkit showing the work of ACOs and End-Stage Renal Disease Care (ESRD) Seamless Care Organizations (ESCOs) participating in the Shared Savings Program, Next Generation ACO Model, and the Comprehensive ESRD Care Model. The toolkit highlights innovative care coordination strategies that ACOs and ESCOs use to collaborate with beneficiaries, clinicians, and post-acute care partners to ensure high-quality, effective care is provided at the right time and in the right setting. The toolkit aims to educate the public about strategies used by ACOs and ESCOs to provide value-based care while also providing actionable ideas to current and prospective ACOs to help them improve or begin operations.

CMS has also released seven case studies to describe innovative initiatives from ACOs and ESRD ESCOs on a variety of topics including engaging beneficiaries, coordinating care in rural settings, and promoting health literacy. Each case study includes detailed results and lessons learned. By sharing their stories, we hope to help current and future Medicare ACOs, and other providers and entities, find new ways to make care better, people healthier, and spending smarter.

doctor working on a laptop with a document open on how to reduce spending

August 28, 2018 – The Centers for Medicare & Medicaid Services (CMS) released the first annual report on the Next Generation Accountable Care Organization (ACO) model. The report provides results from the 18 active Next Gens who participated beginning January 2016. Key findings from the report showed that Next Gen ACOs reduced spending by approximately $100 million (a 1.7 percent reduction), or $62 million after adjusting for shared savings/shared losses. The savings appear to be associated primarily with reductions in hospital and skilled nursing facility costs. Notably, over half the model’s cost and utilization decline was generated by four of the 18 Next Gens.

The Next Gen ACO model was intended to test whether stronger financial incentives could improve care and reduce costs for traditional Medicare beneficiaries. ACOs in the Next Gen model assume 80-100 percent two-sided risk and have additional flexibilities compared to other Medicare ACOs. The ACO program is slated to run through December 31, 2020. The Next Gen ACO model is one of a handful of qualifying Advanced Alternative Payment Models under Medicare’s Quality Payment Program.