21 ACOs Tapped for New, Next Generation Model

There are 21 accountable care organizations (ACOs) slated to participate in the new “Next Generation” model, the Centers for Medicare & Medicaid Services (CMS) has announced.

The Next Generation ACO Model was developed in part to address provider difficulties with the Pioneer ACO program. Like the Pioneer program, the Next Gen model is designed for health networks that already have some experience in coordinating care. The Next Gen program differs in its benchmarking methods from the Pioneer program, and provides increased benefits for participants, such as the ability to provide telehealth and enhanced home health visits following hospitalization. Next Gen participants have the ability to gain greater financial rewards if they can save the Medicare program money while delivering high-quality outcomes—while also being at greater risk if they fail to do so.

Six health systems switched from Pioneer to Next Generation status, meaning the Pioneer program now has been whittled down to only nine participants, after a rash of drop-outs. One of those, Dartmouth-Hitchcock in New Hampshire, specifically cited post-acute restraints as a reason for leaving the Pioneer program. Dartmouth-Hitchcock leaders said they planned to join the Next Generation model, but now have indicated that they are holding off on a decision until 2017.

Among the newly named Next Generation participants is Trinity Health. The organization is one of the biggest multi-institutional Catholic health care delivery systems in the United States. It serves people and communities across 21 states with 88 hospitals and 126 continuing care locations— including hospice, home care, PACE and senior living facilities—that provide almost 2.5 million visits annually.

According to its new website, Trinity Health ACO is a collaboration of Lourdes Health Network, Affinia Health Network, Health Collaborative of Central Ohio, Loyola Physician Partners and Summit Medical Group serving patients in Michigan, Ohio, Illinois and New Jersey.

“We are delighted that Trinity Health ACO is part of the Next Generation ACO Model and its innovative payment and care delivery products,” Barbara Walters, Trinity Health’s executive vice president, population health, said in a prepared statement. “We look forward to celebrating the model’s successes as all participating ACOs prove that transforming the health system into one that incentivizes value is people centered and results in better health, better care and lower costs.”

Written by Mary Kate Nelson