National ACO, LLC to Participate in Second Cohort in the Next Generation ACO Model

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National ACO, LLC is selected by Centers for Medicare & Medicaid Services (CMS) as one of 45 Next Generation ACO Model Participants

The Centers for Medicare & Medicaid Services (CMS) released the names of the 2017 Accountable Care Organizations (ACOs) that will participate in the CMS Next Generation ACO Model second performance year, which included National ACO, LLC (NACO). Those ACOs participating in the Model include new ACOs and ACOs transitioning from other Medicare programs or initiatives.

The Next Generation ACO Model is an innovative alternative to the Medicare Shared Savings Program. It advances the traditional health care delivery system, from a volume-based non-risk fee-for-service (FFS) model to a value-based performance risk-model. The CMS initiative enables NACO and other participants to develop innovative approaches to improving cost and patient population management. The Model also empowers hospitals and physicians to take on greater risk and provides opportunity for greater reward.

The goal of the Next Generation ACO Model is to bridge traditional FFS and Original Medicare payments to alternative payment mechanisms. NACO has chosen to participate in a Population-Based Payments (PBP) arrangement. In addition, the Model offers financial incentives and benefit enhancements that include expanded tele-health services, post-discharge home visits, and a waiver of the three-day skilled nursing facility (SNF) rule. These incentives and enhancements aid in decreasing costs and improving health care coordination and overall patient outcomes.

“The Next Generation ACO Model allows experienced ACOs to employ innovative cutting-edge care coordination mechanisms to improve patient care and value in health care delivery,” said Andre Berger, M.D., CEO of National ACO. “NACO is honored to be part of NGACO Model developing forward-thinking strategies at the forefront of healthcare pioneering change to achieve the “triple aim” goals of reducing wasteful costs and improving quality of care and patient satisfaction.”

Since 2012, the Medicare Shared Savings Program and Pioneer ACO Model have expanded and progressed significantly, demonstrating their ability to improve quality of care and generate savings.

National ACO was successful in the Medicare Shared Savings Program, generating approximately $14.7 M dollars in savings for CMS since its inception in 2013 through 2015. Moving into 2017, NACO has over 300 providers that provide services in California, Tennessee, Colorado, Arizona, and Pennsylvania. “As a physician owned and governed ACO, we continue to provide innovative solutions utilizing program benefits and incentives to effectively manage our patient population. Our move to the Next Generation ACO Model will further our commitment to transitioning from volume to value based care and achieving the Triple Aim,” said Alex Foxman, M.D., F.A.C.P., President, Board Member and Medical Director of National ACO, LLC.

NACO and the qualified organizations were selected through a competitive application process from their fulfillment of eligibility criteria. The partnership of the Department of Health and Human Services, CMS and NACO will be directly affecting over 22,000 beneficiaries in several NACO serviced territories.

Through this NGACO Model, NACO providers can utilize:

  •     Telehealth services and other electronic or mobile utilities to manage care
  •     Opportunities to utilize a waiver for skilled nursing facility admission without a mandated three-day hospital stay
  •     Post-discharge home visits by qualified providers and clinicians following hospital stays
  •     A larger pool of preferred physicians, facilities, specialists, and home health agencies in our various territories

The Next Generation ACO Model program represents an innovative and advanced approach to healthcare delivery and was created to facilitate care coordination among providers. NACO is excited to be an integral part of innovation in our health care delivery system and remains committed to excellence in achieving the “triple aim” in their first year as a new Next Generation Model ACO participant.

For detailed information on the Next Generation ACO Model, visit the CMS Innovation Center website.

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Alex Foxman, M.D.