Health

Biden admin to end Next Gen ACO model after this year

The Biden administration has decided to not extend the Next Generation accountable care organization model, which is expected to end at the end of 2021.

The decision announced late Friday ends a program that called for ACOs to take on more financial risk than the Medicare Shared Savings Program. The model was originally expected to end at the start of 2021 but was extended by the Trump administration due to the pandemic.

The National Association of ACOs said Friday that it was disappointed the Center for Medicare & Medicaid Innovation declined its request to extend the model through 2021.

However, NAACOs said in a statement that it appreciated the administration’s decision to give participants in the model enough time to apply for Direct Contracting, a new model that also requires ACOs to take on more risk.

CMMI had frozen the application period for direct contracting to participate for 2022. NAACOS was concerned that Next Gen ACOs would not have an opportunity to participate in a higher risk financial model and go into MSSP instead.

But the limited opportunity “will be a viable path for some to continue participation in an innovative accountable care model like Direct Contracting,” NAACOS said in a statement. “Non-Next Gens won’t be granted this limited exception unless they have already applied and deferred their exception.”

The Next Gen ACO program faced criticism from the Trump administration. Former Centers for Medicare & Medicaid Services Administrator Seema Verma posted a blog post in January 2020 that the program did not lead to a “statistically significant” impact on spending.

NAACOS countered that the findings were flawed as they compared Next Gen ACO spending to MSSP spending that does not require as much financial risk. They said that the program’s spending should have been counted against traditional fee-for-spending.

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