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Next Gen Accountable Care Organizations Form Coalition to Advance Performance-Based Risk
[September 20, 2018]

Next Gen Accountable Care Organizations Form Coalition to Advance Performance-Based Risk


Twenty-nine Next Generation Accountable Care Organizations (ACOs) have formed a new coalition to advocate for the preservation and expansion of the Next Generation ACO program - a program which has benefited individuals, communities and federal payers since its establishment by the Center for Medicare and Medicaid Innovation in 2016.

"The Next Gen ACO model is the most advanced within the existing Medicare ACO portfolio," said Emily Brower, senior vice president for clinical integration and physician services at Trinity Health. "In the program's pilot endeavors, Next Gen ACOs all over the country have advanced care coordination and care quality, improved patient outcomes, and saved a lot of money for Medicare. Strengthening and sustaining the program would bring only more significant benefits."

As a strong and experienced group, Coalition members will continue their individual dialogues with Centers for Medicare & Medicaid Services (CMS) and the Innovation Center, intending to address issues related to the program's stability and transparency. Over the longer term, the Coalition will identify opportunities for members to shape the Next Generation ACO program so that they can ensure it meets the needs of a delivery system transitioning to higher levels of accountability for both financial and health outcomes. Specifically, the Coalition will focus on developing elements of future payment policy, network desig, and beneficiary engagement.



"Because of our participation in Next Gen, we have established additional care management services for seniors to assist with care transitions and manage complex conditions. These services, previously fragmented in fee-for-service, are now coordinated under the Next Gen program and this has resulted in better care for patients," said Melanie Matthews, Chief Executive Officer of NW Momentum (News - Alert) Health Partners in Washington.

Members of the Coalition look forward to sharing Next Gen ACO best practices and to demonstrating how higher risk within traditional Medicare arrangements accelerates better care and better health.


In a recent report from CMS, Administrator Seema Verma touted the success of the Next Gen program, highlighting program savings of over $61 million in its first performance year across the 18 participants then in the model. There are now 51 Next Gen ACOs. The CMS report also highlights the Next Gen ACOs' widespread use of care management, chronic disease management, and clinical programs, as well as an enhanced focus on primary care, that make this program a success for beneficiaries.

The Coalition will use consensus-based recommendations to advance the program by empowering patients and providers in a model that drives better care at a lower cost.

About the Next Gen program

The Next Generation ACO program is a performance-based risk model in which groups of doctors, hospitals, and other health care providers come together to provide high-quality care at lower costs to their traditional Medicare populations. In this model, Next Gen ACOs must take downside risk. In addition, Next Gen ACOs are offered regulatory flexibility to enable them to better care for their patients while taking a high level of financial and clinical accountability.

About the Next Generation ACO Coalition

The Next Generation ACO Coalition is a convener for program participants to develop and advance consensus-based improvement objectives to promote a strong future for the Next Gen ACO program. A list of members and more information is available at www.nextgencoalition.org


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