The Biden administration has decided not to expand the next generation responsible care organization model, which is expected to end at the end of 2021.
The decision announced Friday night ends a program that called on ACOs to take more financial risks than the Medicare shared savings program. The model was originally scheduled to end in early 2021, but was extended by the Trump administration due to the pandemic.
The National Association of ACOs said on Friday it was disappointed that the Center for Medicare & Medicaid Innovation had declined its request to extend the model until 2021.
However, the NAACOs said in a statement that they appreciated the administration’s decision to give model participants enough time to apply for direct outsourcing, a new model that also requires ACOs to take more risk. .
CMMI had frozen the direct outsourcing request period to participate for 2022. NAACOS was concerned that next-generation ACOs might not have the opportunity to participate in a higher risk financial model and get into MSSP at the place.
But the limited opportunity “will be a viable path for some to continue participating in an innovative and responsible model of care like direct contracting,” NAACOS said in a statement. “Non-Next People will not benefit from this limited exception unless they have already applied and deferred their exception.”
The Next Gen ACO program has been criticized by the Trump administration. Former Centers for Medicare & Medicaid Services administrator Seema Verma published a blog post in January 2020 indicating that the program did not have a “statistically significant” impact on spending.
NAACOS countered that the results were wrong when comparing next-generation ACO spending to MSSP spending that doesn’t require as much financial risk. They said program expenses should have been charged against traditional fee-for-service.