“Next-Generation ACO” Model Is CMS’s Newest Effort to Encourage More ACO Risk

Houston Medical Times April 2015

Philo D. Hall, an Associate in the Health Care and Life Sciences practice, in the firm's Washington, DC, office, and Larry Kocot, a former EBG attorney, authored an article in Houston Medical Times, titled "'Next-Generation ACO' Model Is CMS's Newest Effort to Encourage More ACO Risk."

Following is an excerpt (see below for a PDF of the full article):

On March 10, 2015, the Centers for Medicare & Medicaid Services’ (“CMS’s”) Center for Medicare and Medicaid Innovation (“Innovation Center”) announced a demonstration project incorporating new risk models for reimbursement of accountable care organizations (“ACOs”) serving Medicare beneficiaries.

Fresh on the heels of CMS’s recently announced goal of tying 50 percent of Medicare fee-for-service payments to value-based payment methodologies by the end of 2018, the Next Generation ACO Model (“NGAM”) joins the Innovation Center’s Pioneer ACO Model and the Medicare Shared Savings Program (“MSSP”) as an additional option for Medicare providers to organize together to provide coordinated, high-quality care at lower cost, with the potential to earn higher compensation.