Next Gen ACOs Saved Medicare $559M, Improved Quality in 2019

Stakeholders push CMS to make the program permanent.

Medicare's Next Generation Accountable Care Organizations saved the federal healthcare program $559 million and saw quality scores rise measurably in 2019, according to partial 2019 performance data made public this week.

Clif Gaus, president and CEO of the National Association of ACOs, says the savings are likely even higher because the partial results account for only 37 of the 41 Next Gen ACOs participating in 2019. Four of the Next Gen ACOs deferred financial settlements.

"For every year of the program, Next Gen ACOs yielded savings for Medicare money while also showing an improvement in quality. Very few programs CMS has developed over the years can say that," Gaus said.

Because of the COVID-19 pandemic, the Centers for Medicare & Medicaid Services extended the Next Gen program, which was due to sunset at the end of 2020, through 2021.

Gaus urged CMS to "make the Next Gen model a permanent fixture in Medicare, either as a stand-alone program or an option within the Shared Savings Program."

He said the data show that ACOs met an average quality score of 93.7% out of a perfect score of 100, improving care for 1.2 million seniors.

After accounting for shared savings paid to ACOs for holding down costs and hitting quality targets as well as shared losses and discounts paid to the government, the Next Gen program netted $204 million to Medicare in 2019 alone.

In 2018 Next Gen ACOs saved Medicare $406 million and netted $185 million after shared savings and losses.