https://mailchi.mp/ea16393ac3c3/gist-weekly-march-22-2024?e=d1e747d2d8

On Wednesday, CMS unveiled the ACO Primary Care Flex Model, which will offer participating accountable care organizations (ACOs)—whether new or renewing—in the Medicare Shared Savings Program (MSSP) a one-time, advanced payment along with monthly prospective payments, rather than shared savings at the end of a given performance year.

Set to begin in January 2025, the five-year, voluntary model is targeted at “low-revenue” ACOs (as defined by their share of Medicare Parts A and B spending for assigned beneficiaries). The National Association of ACOs (NAACOS), which supports the ACO Primary Care Flex Model, has asked that CMS reconsider its exclusion of high-revenue ACOs, saying that the exclusion prevents independent primary care practices that have already joined a health system ACO from being able to access the benefits of the new model.  

The Gist: This new model is designed to better support smaller ACOs—which tend to be physician-only—by giving them access to a more stable cash flow.

The highest-performing ACOs in the MSSP have been smaller, physician-only ACOs with relatively more primary care physicians and fewer specialists.

With less than half of traditional Medicare beneficiaries in an ACO as of January 2024, CMS must entice more providers to join or form ACOs if it is to achieve its goal of getting every Medicare beneficiary into an accountable care arrangement by 2030.