Updated with list: Majority of Next Generation ACOs earned shared savings
The National Association of ACOs is urging CMS to make program permanent.
All but two of 39 accountable care organizations reporting outcomes in the Next Generation ACO model earned shared savings rather than owed money, a figure the National Association of ACOs touts as a success for value-based, capitated payments.
Next Generation is Medicare's model of greatest risk. NAACOS wants to see the four-year model made permanent.
Collectively, Next Gen ACOs saved Medicare $559 million last year, according to partial 2019 performance data made available by the Centers for Medicare and Medicaid Services.
WHY THIS MATTERS
ACOs are accountable for the cost and quality of beneficiary care. They earn the right to share with Medicare savings generated if certain spending and quality metrics are met.
ACOs hit an average quality score of 93.7% out of a perfect score of 100, improving care for 1.2 million seniors, according to NAACOS.
After accounting for shared savings paid to ACOs for holding down costs and hitting quality targets as well as shared losses and discounts paid to the government, the Next Gen program netted $204 million to Medicare in 2019. By comparison, Next Gen ACOs saved Medicare $406 million in 2018 and netted $185 million after shared savings and losses.
THE LARGER TREND
Launched in 2016, and extended by a year to end at the end of 2021, Next Gen builds off former innovation models, such as Pioneer, which started in 2012. CMS extended the program due to the COVID-19 pandemic.
ON THE RECORD
"For every year of the program, Next Gen ACOs yielded savings for Medicare money while also showing an improvement in quality. Very few programs CMS has developed over the years can say that," said Clif Gaus, president and CEO of the National Association of ACOs. "NAACOS continues to call on CMS to make the Next Gen model a permanent fixture in Medicare, either as a stand-alone program or an option within the Shared Savings Program."
| ACO Name | Total Aligned Beneficiaries | Total Benchmark Expenditures | Total Actual Expenditures for Aligned Beneficiaries | Earned Shared Savings Payments/Owe Shared Losses |
|---|---|---|---|---|
| Steward Integrated Care Network, Inc. | 116,246 | $1,544,646,145 | $1,522,698,357 | $17,207,066 |
| ThedaCare ACO, LLC | 15,874 | $144,559,315 | $143,365,443 | $935,996 |
| Pioneer Valley Accountable Care, LLC | 44,201 | $520,627,651 | $514,213,418 | $5,028,759 |
| CHESS NEXTGEN LLC | 29,367 | $337,266,985 | $327,680,918 | $9,394,345 |
| Accountable Care Coalition of Southeast Texas, Inc | 17,389 | $236,869,357 | $219,148,172 | $17,366,762 |
| Trinity Health ACO, Inc. | 77,901 | $941,696,538 | $910,594,340 | $24,384,123 |
| Henry Ford Physicians Accountable Care Organization, LLC | 26,572 | $359,326,038 | $352,466,223 | $5,378,095 |
| Deaconess Care Integration, LLC | 39,968 | $439,346,234 | $427,837,229 | $9,023,060 |
| Park Nicollet Clinic | 14,229 | $150,026,494 | $147,574,093 | $1,922,682 |
| UnityPoint Accountable Care L.C. | 100,200 | $1,071,112,979 | $1,016,449,896 | $41,987,629 |
| Physician Partners LTD. | 12,403 | $122,716,225 | $119,682,569 | $2,378,386 |
| Triad HealthCare Network, L.L.C. | 28,801 | $300,956,244 | $291,697,913 | $9,073,165 |
| Atrius Health, Inc. | 39,354 | $471,519,011 | $452,676,439 | $18,465,721 |
| HCP California, LLC | 30,217 | $423,063,832 | $435,448,822 | ($9,907,993) |
| NW Momentum Health Partners ACO, LLC | 13,787 | $131,396,899 | $129,738,056 | $1,300,533 |
| UT Southwestern Accountable Care Network | 94,625 | $1,239,092,055 | $1,187,431,915 | $50,626,938 |
| Accountable Care Options, LLC | 10,952 | $150,604,322 | $149,668,641 | $916,968 |
| St. Luke's Clinic Coordinated Care, LTD | 32,489 | $346,525,684 | $317,278,019 | $22,930,169 |
| ProHealth Solutions, LLC | 15,809 | $163,214,109 | $158,499,385 | $3,696,343 |
| Indiana University Health | 63,692 | $753,934,320 | $711,353,369 | $29,554,225 |
| Carilion Clinic Medicare Shared Savings Company, LLC | 52,775 | $536,490,623 | $510,506,034 | $20,371,918 |
| Arizona Care Network, LLC | 35,751 | $399,075,814 | $397,495,209 | $1,239,195 |
| APA ACO, Inc. | 30,740 | $504,936,872 | $467,646,269 | $19,793,525 |
| UNC Senior Alliance, LLC | 30,357 | $316,423,039 | $301,828,764 | $14,302,389 |
| UW Health ACO, Inc. | 27,498 | $267,722,517 | $256,244,488 | $8,998,775 |
| Reliant Medical Group, Inc | 10,851 | $140,684,947 | $130,546,703 | $9,935,480 |
| Reliance Next Gen ACO, LLC | 12,668 | $169,196,334 | $158,615,389 | $8,295,461 |
| Primary Care Alliance | 13,011 | $163,293,662 | $142,200,984 | $20,670,824 |
| Revere Health | 15,399 | $176,343,855 | $171,698,950 | $3,641,606 |
| CoxHealth Accountable Care, LLC | 19,531 | $183,521,482 | $184,852,277 | ($1,064,636) |
| Franciscan Missionaries of Our Lady Health System Clinical Network, LLC | 25,270 | $280,978,730 | $260,736,786 | $16,521,549 |
| CareMount ACO | 24,664 | $305,582,388 | $291,043,463 | $11,398,517 |
| Primaria ACO, LLC | 28,656 | $336,591,843 | $313,302,980 | $22,823,085 |
| Best Care Collaborative | 14,795 | $176,349,676 | $168,947,631 | $7,254,004 |
| Accountable Care Coalition of Tennessee, LLC | 22,489 | $221,941,879 | $205,764,102 | $15,854,222 |
| Torrance Memorial Integrated Physicians, LLC | 12,139 | $171,013,621 | $160,358,836 | $6,703,734 |
| NEQCA Accountable Care, Inc | 35,261 | $506,768,205 | $489,561,739 | $13,489,869 |
Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com
