May 30, 2019
The Honorable Alex Azar Secretary
US Department of Health & Human Services
Hubert H. Humphrey Building
200 Independence Avenue SW
Washington, DC 20201
Re: Permanence for the Next Generation Accountable Care Organization (NGACO) Model
Dear Secretary Azar:
The undersigned organizations write to encourage the Department of Health and Human Services to expand the duration and scope of the NGACO model to be a permanent, voluntary offering in the performance-based risk model portfolio beginning with the 2021 performance year. Participants in the NGACO model have demonstrated success in terms of controlling costs for Medicare and improving care for seniors. Extending the availability of this model will allow additional providers to pursue the transition to improved care outcomes and greater levels of financial accountability.
We believe there is sufficient evidence of the model successfully meeting the criteria under Section 1115A authority to expand its duration and scope of participation. However, we call on the agency to begin the work of incorporating the most successful features of the NGACO program into Pathways to Success immediately through regulation (as the agency did with the Pioneer ACO program).1 Making this option available for future participation will support a smooth transition into performance-based risk arrangements for more providers while also building on the lessons learned from successful Innovation Center pilots.
NGACOs have demonstrated that the model saves money and improves quality. For example, program participants achieved net savings to Medicare of $62.12 million in the program’s first year and again produced savings of over $164 million across 44 participants in 2017 based on industry calculations of Centers for Medicare & Medicaid Services (CMS) data while we await the public release of the 2017 evaluation report.
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