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:
- 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.
- 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.
- The program will launch Jan. 1, 2025, and is open to ACOs participating in the Medicare shared-savings model.
- CMS will select 130 ACOs to participate. The agency plans to publish a request for applications in the second quarter of 2024.
- 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."
Subscribe to the following topics: cmspayment modelprimary caremedicare beneficiariesaco primary care flex model