River Health ACO Chosen for CMS Initiative to Build on Success of ACOS

Newswise — River Health ACO, a partnership of PinnacleHealth System, Susquehanna Health and affiliates, has been selected to participate in the Centers for Medicare & Medicaid Services’ (CMS) new accountable care organization (ACO) model called the Next Generation ACO Model (NGACO Model). This model advances the Administration’s health care system goals and builds on experience from the Pioneer ACO Model and the Medicare Shared Savings Program. Through this new model, CMS will partner with River Health ACO and other ACOs that are experienced in coordinating care for populations of patients and whose provider groups are ready to assume higher levels of financial risk and reward. This is in accordance with the Administration’s goals, announced on January 26, 2015, to move 30 percent of traditional Medicare fee-for-service payments into alternative payment models that pay providers based on the quality rather than the quantity of care they provide patients by 2016 – and 50 percent by 2018.

“River Health ACO is pleased to have been selected for participation in the Next Generation ACO Model,” said Les Duncan, vice president of accountable care initiatives, River Health ACO. “This model is one of many innovative payment and care delivery models created under the Affordable Care Act, and is an important step towards advancing models of care that reward value over volume in care delivery.”

Since Medicare Shared Savings Program and Pioneer ACOs began in 2012, and now, the Next Generation ACOs – Medicare ACOs have grown to over 477 nationwide, serving nearly 8.9 million beneficiaries. The results from the past 4 years have demonstrated that as ACOs gain more experience in these programs, their performance improves in providing better quality of care for beneficiaries, while producing savings.

The 21 ACOs participating in the NGACO Model in 2016 have significant experience coordinating care for populations of patients through initiatives, including, but not limited to, the Medicare Shared Savings Program and the Pioneer ACO Model. The NGACO Model organizations represent a variety of provider organizations and geographic regions, and were selected by fulfilling specific eligibility criteria outlined in the Request for Applications found at the Next Generation ACO Model web page. These organizations were selected through an open and competitive process from a large applicant pool that included many qualified organizations.

“We look forward to working with our newly selected Next Generation ACO model participants to move our health care system toward one that delivers better care, smarter spending and healthier people,” said Patrick Conway, deputy administrator for Innovation and Quality and chief medical officer for CMS. “This ACO model responds to stakeholder requests for the next stage of the ACO model that enables greater engagement of beneficiaries, a more predictable, prospective financial model, and the flexibility to utilize additional tools to coordinate care for beneficiaries.”

For more information on the Next Generation ACO Model, please visit the Next Generation ACO Model web page.