Next Generation ACO Model: Helping Make Care Accountable

by | May 26, 2015 | Choosing Health Equity

To further expand accountable care across the health care system, the U.S. Department of Health and Human Services (HHS) recently announced the Next Generation Accountable Care Organization (ACO) program. This pilot program will test and evaluate new approaches to delivering coordinated care. It will offer providers another model of care to advance the “Triple Aim” of better care, better outcomes and lower costs.

The Next Generation ACO program builds on work HHS is already doing in Medicare, Medicaid and the private sector to align payment with quality and value, rather than volume. And it will be another iteration of the ACO model, which is already showing progress in improving the quality of care, reducing costs and enhancing the patient experience. For example, the Pioneer ACO Model generated more than $384 million in savings to Medicare over two years; that’s an average of approximately $300 in savings per participating beneficiary per year.

When designed well, ACOs can help improve patient access to appropriate and timely care; support patients, caregivers and providers in building collaborative relationships; and assure patients they are getting the best quality care. But in order for ACOs to achieve their full promise, patients and caregivers need to have meaningful information about how they work, how the quality of their care is being measured, and the financial and governance structures of their ACOs.

The Next Generation ACO model is an opportunity to move the health care system one step closer to accountable care. To help shape this new model, 12 consumer advocacy groups, including the National Partnership, recently submitted recommendations to HHS to ensure that Next Generation ACOs partner with patients and family caregivers in the design and delivery of care. In our letter, we express support for HHS’ emphasis on effective care coordination, team-based care and connections to community resources, while offering critiques of proposed financial rewards and the lack of reference to electronic health record access. The letter can be found here; a related news release is here.