Advance Payment ACO Model

The Advance Payment Model is designed for physician-based and rural providers who have come together voluntarily to give coordinated high quality care to the Medicare patients they serve. Through the Advance Payment ACO Model, selected participants will receive upfront and monthly payments, which they can use to make important investments in their care coordination infrastructure.

Select anywhere on the map below to view the interactive version ADV mapped

There are 35 ACOs participating in the Advance Payment ACO Model. (List)

To view an interactive map of this Model, visit the Where Innovation is Happening page.

Background

In developing the Advance Payment ACO Model, CMS is responding to input from stakeholders received on the proposed rule for the Shared Savings Program, and comments received (PDF) on the initial Advance Payment Model announced in May 2011. Some providers have expressed a concern about their lack of ready access to the capital needed to invest in infrastructure and staff for care coordination. The Advance Payment ACO Model is meant to help smaller ACOs with less access to capital participate in the Shared Savings Program.

Initiative Details

Through the Advance Payment ACO Model, selected organizations will receive an advance on the shared savings they are expected to earn. Participating ACOs will receive three types of payments:

  • An upfront, fixed payment: Each ACO will receive a fixed payment.
  • An upfront, variable payment: Each ACO will receive a payment based on the number of its historically-assigned beneficiaries.
  • A monthly payment of varying amount depending on the size of the ACO: Each ACO will receive a monthly payment based on the number of its historically-assigned beneficiaries.

Advance payments are structured in this manner to acknowledge that new ACOs will have both fixed and variable start-up costs.

Additional Information

Questions about the Advance Payment application, or the Advance Payment Model generally, can be sent to advpayaco@cms.hhs.gov.