Building upon experience from the Pioneer ACO Model and the Medicare Shared Savings Program (Shared Savings Program), the Next Generation ACO Model offered an exciting opportunity in accountable care—one that set predictable financial targets, enabled providers and beneficiaries greater opportunities to coordinate care, and aimed to attain the highest quality standards of care.
There were 35 ACOs participating in the Next Generation ACO Model.To view an interactive map of this Model, visit the Where Innovation is Happening page, and select this model from the drop-down menu on the left side of the page.
Accountable Care Coalition of Southeast Texas, Inc.
- Accountable Care Coalition of Tennessee, LLC
- APA ACO, Inc.
- Arizona Care Network, LLC
- Atrius Health, Inc.
- Bellin Health Partners, Inc.
- Best Care Collaborative
- CareMount ACO
- Carilion Clinic's Doctors Connected
- CHESS Health Solutions
- Deaconess Care Integration, LLC
- Franciscan Missionaries of Our Lady Health System Clinical Network, LLC
- Henry Ford Physicians Accountable Care Organization, LLC
- Indiana University Health
- Mary Washington Health Alliance LLC
- NEQCA Accountable Care, Inc.
- NW Momentum Health Partners ACO, LLC
- Park Nicollet Net Generation Accountable Care Organization
- Pioneer Valley Accountable Care, LLC
- Primaria ACO, LLC
- Primary Care Alliance
- ProHealth Solutions, LLC
- Prospect ACO Northeast, LLC
- Reliance Next Gen ACO, LLC
- Reliant Medical Group, Inc.
- Revere Health
- St. Luke's Clinic Coordinated Care, LTD
- ThedaCare ACO, LLC
- Torrance Memorial Integrated Physicians, LLC
- Triad HealthCare Network, LLC
- Trinity Health ACO, Inc.
- UNC Senior Alliance, LLC
- UnityPoint Accountable Care, LC
If you are a Medicare beneficiary seeking information about this model, please review the section below titled I'm a Medicare Beneficiary, so what does this mean for me?
Medicare ACOs are comprised of groups of doctors, hospitals, and other health care providers and suppliers who come together voluntarily to provide coordinated, high-quality care at lower costs to their Original Medicare patients. ACOs are patient-centered organizations where the patient and providers are true partners in care decisions. Medicare beneficiaries have better control over their health care, and providers have better information about their patients’ medical history and better relationships with patients’ other providers. Provider participation in ACOs is purely voluntary, and participating patients see no change in their Original Medicare benefits and keep their freedom to see any Medicare provider. When an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, it shares in the savings it achieves for the Medicare program.
The Next Generation ACO Model was an initiative for ACOs that were experienced in coordinating care for populations of patients. It allowed these provider groups to assume higher levels of financial risk and reward than were available under the Shared Savings Program (MSSP). The goal of the Model was to test whether strong financial incentives for ACOs, coupled with tools to support better patient engagement and care management, could improve health outcomes and lower expenditures for Original Medicare fee-for-service (FFS) beneficiaries.
Included in the Next Generation ACO Model were strong patient protections to ensure that patients had access to and received high-quality care. Like other Medicare ACO initiatives, this Model was evaluated on its ability to deliver better care for individuals, better health for populations, and lower growth in expenditures. This was in accordance with the Department of Health and Human Services’ “Better, Smarter, Healthier” approach to improving our nation’s health care and setting clear, measurable goals and a timeline to move the Medicare program -- and the health care system at large -- toward paying providers based on the quality rather than the quantity of care they provide to patients. In addition, CMS has publicly reported the performance of the Next Generation Pioneer ACOs on quality metrics, including patient experience ratings, on its website.
Financial and Quality Results
- Performance Year 1 (2016) (XLS)
- Performance Year 2 (2017) (XLS)
- Performance Year 3 (2018) (XLS)
- Performance Year 4 (2019) Partial Results Cover Letter (PDF)
- Performance Year 4 (2019) Partial Results (XLS)
- Performance Year 4 (2019) Full Results (XLS)
- Performance Year 5 (2020) (XLS)
The Model consisted of three initial performance years and two optional one-year extensions. Questions regarding the Next Generation ACO Model can be directed to NextGenerationACOModel@cms.hhs.gov.
Benefit enhancements were waivers of certain Medicare service rules (e.g., telehealth, post-discharge home visits, and the three-day skilled nursing facility rule), and initiatives intended to assist Next Generation Accountable Care Organizations in improving care for and engagement of their beneficiaries.
- Telehealth Expansion Waiver (PDF)
- Three-Day Skilled Nursing Facility Waiver (PDF)
- Cost Sharing for Part B Medicare Services (PDF)
- Chronic Disease Management Reward (Gift Card) (PDF)
- Voluntary Alignment Frequently Asked Questions (PDF)
- Post-Discharge and Care Management Home Visit Waivers (PDF)
- What is the Telehealth Waiver? (PDF)
- What is the Three-Day Skilled Nursing Facility Waiver? (PDF)
- What is the Post-Discharge Home Visit Waiver? (PDF)
- What is the Care Management Home Visit Waiver? (PDF)
- What is the Chronic Disease Reward (Gift Card) Program? (PDF)
- What is Cost Sharing Support for Part B Medicare Services? (PDF)
- Voluntary Alignment Frequently Asked Questions for beneficiaries & caregivers (PDF)
- Annual Wellness Visit/Coordinated Care Reward Check Frequently Asked Questions (PDF)
Latest Evaluation Reports
- Two Pager: At-A-Glance - Fourth Evaluation Report (PDF)
Prior Evaluation Reports
- Two Pager: At-A-Glance - Third Evaluation Report (PDF)
- Two Pager: At-A-Glance - Second Evaluation Report (PDF)
- Two Pager: At-A-Glance - First Evaluation Report (PDF)
- Next Generation ACO Model Benchmark Methodology for Performance Years 1-3 (PDF)
- Next Generation ACO Model Benchmark Methodology for Performance Year 4 (PDF)
- Next Generation ACO Model Benchmark Methodology for Performance Year 6 (PDF)
- Next Generation ACO Model Financial and Quality Results Performance Year 1 (XLS)
- Next Generation ACO Model Financial and Quality Results Performance Year 2 (XLS)
- Fact Sheet
- Press Release
- Frequently Asked Questions (PDF)
- 2021 Frequently Asked Questions (PDF)
- Blog: Number of ACOs Taking Risk for Cost Increases Doubles under “Pathways to Success"
- Archived Materials
- Beneficiary Engagement Toolkit (PDF)
- Care Coordination Toolkit (PDF)
- Provider Engagement Toolkit (PDF)
- Care Transformation Toolkit (PDF) (January 2021)
- Integra Community Care Network's Approach to Advance Care Planning (PDF) (November 2019)
- Southwestern Health Resources ACO Three-Day Rule Waiver: Approach to Communication and
- Atrius Health: Improving Behavioral Health Care for Medicare Beneficiaries (PDF)
- UnityPoint ACO's Home Visit Program (PDF) (July 2019)
- Bellin Health Partners: The Evolution of Annual Wellness Visits (PDF)
- Henry Ford Accountable Care Organization's Beneficiary Engagement Strategy (PDF)
- Montefiore Accountable Care Organization's Provider Engagement Strategy (PDF)
- Partners HealthCare ACO and the Three-Day Rule Waiver: Implementation Approach and Lessons Learned (PDF)