• June 15, 2021

CMS will not lengthen the Subsequent Technology ACO Mannequin by 2022

May 23, 2021

CMS will not lengthen the Subsequent Technology ACO Mannequin by 2022 however will enable members to use for the usual monitor of its International and Skilled Direct Contracting Mannequin, the company stated in a letter to Subsequent Gens on Friday.

The American Hospital Affiliation, Nationwide Affiliation of Accountable Care Organizations and different supplier teams had lobbied the Biden administration to increase the Subsequent Gen ACO Mannequin by the tip of subsequent yr. And their calls grew extra pressing after CMS’ Middle for Medicare and Medicaid Innovation introduced it might pause new functions for its International and Skilled Direct Contracting Mannequin in April. The choice had left many direct contracting entities with out a residence for 2022, forcing them to reevaluate their plans with out realizing what may come subsequent.

Subsequent Gens did not get the extension that they had sought, however they did get some reduction when CMMI introduced they’d be capable of be a part of the GPDC Mannequin in the event that they met the company’s {qualifications}.

“We recognize at the moment’s transfer to permit Subsequent Gen ACOs a restricted alternative to use for direct contracting to beginning subsequent yr. This shall be a viable path for some to proceed participation in an modern, accountable care mannequin like direct contracting,” Nationwide Affiliation of ACOs CEO Clif Gaus stated in a press release.

Different ACOs like these within the Medicare Shared Financial savings Program nonetheless cannot be a part of the GPDC Mannequin until they utilized for it final yr and deferred their participation.

With out additional motion from the company, Subsequent Gens would have needed to sit out the yr or transfer into the MSSP’s Enhanced monitor. That may have allowed them to remain in an alternate fee mannequin however decreased their danger from 100% to 75%. And it might have given Subsequent Gen ACOs much less flexibility, together with the power to regulate downstream funds.

Specialists had break up on whether or not the company ought to hold Subsequent Gen in place for an additional yr. Some argued it might enable Subsequent Gen ACOs to proceed to function in a full-risk mannequin till CMMI figures out its plans for value-based care. Others imagine it might solely delay the inevitable and take away assets that might be dedicated to its successor, as Subsequent Gens in all probability would not have invested a lot within the mannequin since it might have solely lasted another yr.

CMMI’s newest transfer would enable Subsequent Gens to remain in a full-risk mannequin and provides them new freedoms.

“Subsequent Technology ACOs have already constructed the operational capability and processes to do value-based well being care transformation work, and we imagine there can be vital worth in leveraging their expertise and operational capabilities by providing eligible Subsequent Technology ACOs the chance to take part within the GPDC Mannequin check,” the letter stated.

Subsequent Gens have till June 14 to exhibit that they are capable of take part within the GPDC Mannequin.

However NAACOs will proceed lobbying for a everlasting, Subsequent Gen-like ACO mannequin that gives a greater bridge between MSSP Enhanced and the complete capitation choice below Direct Contracting, Gaus stated in a press release.

“With further time, the (CMS)¬†ought to think about using Innovation Middle authority to check sure profitable and common ideas below Subsequent Gen inside the Shared Financial savings Program, because it did with Monitor 1+,” the assertion stated.

Source link