The Next Generation (NG) Accountable Care Organization (ACO) model expands on the Pioneer and Medicare Shared Savings Program ACOs, offering financial incentives to providers working together in groups. These incentives are intended to reward providers that maintain or improve quality of care while reducing related costs for Medicare Fee-for-Service beneficiaries.
Under the NG ACO model, ACOs have more flexibility to assume greater risk and potentially earn higher incentives, while offering more predictable financial targets and expanded choice in the design of provider payment and enrollee benefits. The Center for Medicare & Medicaid Innovation (the Innovation Center) has asked NORC to assess the performance of three cohorts (2016, 2017, and 2018) NG ACOs over multi-year performance periods.
NORC’s mixed-methods evaluation will describe ACO and provider features; characterize implementation across the ACOs; estimate the impact of the NG ACO model on cost of care and measures of utilization, quality, and beneficiary health; and identify variation in model impact and replicability.
First Wave (2016)
NORC used a variety of primary and secondary sources to evaluate the first wave of data collected in 2016, including claims data, primary data collected through ACO telephone interviews and site visits, and surveys conducted directly with ACO-related stakeholders (members of each ACO’s leadership team, its clinicians, and beneficiaries). Early results show promise with regard to improved quality and cost savings made possible by a combination of factors offered by the NG model, including flexible enrollee benefits and provider payment plans, as well as a choice of risk-sharing options for the organizations.
The initial NGACO report and findings were presented to CMS in early 2018 and are publicly available on the CMS website: