Carilion Clinic chosen for CMS initiative to build on success of Accountable Care Organizations

Carilion Clinic has been selected to participate in the Centers for Medicare & Medicaid Services’ (CMS’) accountable care organization (ACO) initiative called the Next Generation ACO Model. The goal for the Model is to improve health outcomes and lower costs.
 
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.
 
The ACO program began in 2012 with the Medicare Shared Savings Program and Pioneer ACO Model. There are now more than 572 ACOs nationwide, serving nearly 12.3 million Medicare and/or Medicaid beneficiaries. Results from the past five years have shown that as ACOs can provide better quality of care for beneficiaries while producing savings.
 
The Next Generation ACO Model is an initiative for ACOs that are experienced in coordinating care for populations of patients, like Carilion Clinic. It will allow these provider groups to assume higher levels of financial risk and reward than are available under the current Pioneer Model and the Medicare Shared Savings Program. The goal of the Model is to test whether strong financial incentives for ACOs, coupled with tools to support better patient engagement and care management, can improve health outcomes and lower expenditures for Original Medicare fee-for-service (FFS) beneficiaries.
 
The Next Generation ACO Model advances the administration’s health care system goals and contributes to the Health and Human Services Secretary’s goals announced in 2015 to move an increasing percentage of Medicare payments into models that pay providers based on the quality rather than the quantity of care they provide patients.
 
“We are excited to participate in the Next Generation ACO Model because of the opportunity it provides for our patients and our community,” said Patrice M. Weiss, M.D., Executive Vice President and Chief Medical Officer for Carilion Clinic. “It’s an important step to help us achieve better outcomes, better patient experiences, lower cost and better experiences for our teams who are providing care.”
 
The 45 total ACOs participating in the Next Generation ACO Model in 2017 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 organizations participating in the Next Generation ACO Model represent a variety of provider organizations and geographic regions, and they were selected by fulfilling specific eligibility criteria outlined in a Request for Applications (RFA) 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.
 
“By listening to physicians and engaging them as partners, CMS has been able to develop innovative payment reforms that bring physicians back to the core practice of medicine – caring for the patient,” said Acting Administrator Andy Slavitt. “By reducing regulatory burden and paying for quality, CMS is offering solutions that improve the quality of services our beneficiaries receive and reduce costs, to help ensure the Medicare program is sustainable for generations to come.”
 
For more information on the NGACO Model, please visit the Next Generation ACO Model web page.
 
 
ABOUT THE CENTER FOR MEDICARE AND MEDICAID INNOVATION
The Center for Medicare and Medicaid Innovation (CMS Innovation Center) was created by the Affordable Care Act to test innovative payment and service delivery models to reduce program expenditures while preserving or enhancing the quality of care for Medicare, Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries. The CMS Innovation Center is committed to transforming Medicare, Medicaid and CHIP and is expected to help deliver better care for individuals, better health for populations, and lower growth in expenditures for Medicare, Medicaid and CHIP beneficiaries.
 
ABOUT CARILION CLINIC
Carilion Clinic is a not-for-profit healthcare organization serving nearly one million people in Virginia through hospitals, outpatient specialty centers and advanced primary care practices. Led by multi-specialty physician teams with a shared philosophy that puts the patient first, Carilion is committed to improving outcomes for every patient while advancing the quality of care through medical education and research. For more information visit www.CarilionClinic.org/about

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