CMS adds new ACO model: 5 things to know

CMS will introduce a new payment model designed to spur innovation in primary care for Medicare beneficiaries. 

The ACO Primary Care Flex Model will provide a one-time advance payment and monthly prospective primary care payments to ACOs, according to a March 19 news release from CMS. 

Here are five things to know about the model: 

  1. The model is designed to improve beneficiaries' care experience and outcomes, grow participation in the Medicare shared-savings model, and limit dependence on visit-based service volume. 

  2. The model strengthens incentives for providers to form ACOs and supports CMS' goal of increasing the number of Medicare beneficiaries in value-based care arrangements, Liz Fowler, PhD, director of the Center for Medicare and Medicaid Innovation, said in a March 19 news release. 

  3. The program will launch Jan. 1, 2025, and is open to ACOs participating in the Medicare shared-savings model. 

  4. CMS will select 130 ACOs to participate. The agency plans to publish a request for applications in the second quarter of 2024. 

  5. In a statement, Clif Gaus, president and CEO of the National Association of ACOs, praised the model but asked that the agency reconsider excluding high-revenue ACOs from the model, which "prevents independent primary care practices who have partnered with their local health systems from taking advantage of these much needed innovations." 

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Top 40 articles from the past 6 months