21 Sign up for Next Generation Program

Robert Calandra

The Next Generation ACO program has gotten off the ground with 21 organizations agreeing to participate this year.

That’s a solid start for a program that was expected to have between 15 and 20 provider organizations during it’s first two years.

Chris Dawe

“This level of participation shows that CMS is listening to the experiences of ACOs and refining their program to make it more financially and operationally viable for providers,” says Chris Dawe, a managing partner for policy and transformation at Evolent Health(link is external), a consulting firm in Arlington, Va., that provides ACO advice.

Dawe says the number of participants also shows that providers are realizing the importance of forming alliances now to create high-performing networks rather than wait on the sideline and risk losing market share.

Roughly 30 million Americans are fee-for-service Medicare beneficiaries. Almost 9 million of them are now receiving care from providers organized as ACOs.

Next Generation addresses many of the provider complaints that plagued its predecessor, the Pioneer program.

The Pioneer program started with 32 participants in 2012 and has just nine now.  One of the major issues of the Pioneer program has been the quality benchmarks used to determine whether an organization would get shared savings by controlling health care utilization and costs.  The Pioneer program has used a three-year, national historical baseline trend. The Next Generation program  uses a one-year historical baseline that factors in regional differences.

The new program also offers new shared savings and loss options, attractive benefit enhancements for both providers and beneficiaries, and a capitation option for providers in 2017.

Here is a list of the 21 organizations in the Next Generation program:

Organizations Location
Accountable Care Coalition of Southeast Texas Inc. Houston, Texas
Baroma Accountable Care, LLC Miami, Florida
Beacon Health Brewer, Maine
Bellin Health DBA Physician Partners Green Bay, Wisconsin
Cornerstone Health Enablement Strategic Solutions (CHESS) High Point, North Carolina
Deaconess Care Integration Evansville, Indiana
Henry Ford Physician Accountable Care Organization Detroit, Michigan
Iowa Health Accountable Care West Des Moines, Iowa
Optum Accountable Care Organization Phoenix, Arizona
MemorialCare Regional ACO Fountain Valley, California
OSF Healthcare System Peoria, Illinois
Park Nicollet Health Services St. Louis Park, Minnesota
Pioneer Valley Accountable Care Springfield, Massachusetts
Prospect ACO CA Los Angeles, California
Regal Medical Group Northridge, California
River Health ACO Harrisburg, Pennsylvania
Steward Integrated Care Network Boston, Massachusetts
ThedaCare ACO Appleton, Wisconsin
Triad HealthCare Network Greensboro, North Carolina
Trinity Health ACO Livonia, Michigan
WakeMed Key Community Care Raleigh, North Carolina

The nine remaining Pioneer ACOs are Allina Health in Minneapolis; Atrius Health in Newton, Mass.; Banner Health Network in Mesa, Ariz.; Beth Israel Deaconess Care Organization in Boston; Fairview Health Services in Minneapolis; Michigan Pioneer in Southfield, Mich.; Monarch HealthCare in Irvine, Calif.; Montefiore ACO in Yonkers, N.Y., and Partners Community Healthcare Inc. in Boston.