CMS launches new Advance Payment ACO Model

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The Centers for Medicare & Medicaid Services Innovation Center has announced a new round of applications relating to the Advance Payment Accountable Care Organization (ACO) Model.

On Aug. 1, CMS will begin accepting applications for a new round of Advance Payment Model ACOs that would begin Jan. 1, 2013. The Advance Payment Model is designed for physician-based and rural providers who have come together voluntarily to give coordinated high quality care to the Medicare patients they serve.

Through the Advance Payment ACO Model, selected organizations will receive an advance on the shared savings they are expected to earn. According to CMS, participating ACOs will receive three types of payments:

  • An upfront, fixed payment;
  • An upfront, variable payment based on the number of its historically-assigned beneficiaries; and
  • A monthly payment of varying amount depending on the size of the ACO.

Regarding eligibility, only ACOs that enter the Medicare Shared Savings Program in April or July are eligible. “Organizations interested in participating in the Advance Payment Model must apply to both the Medicare Shared Savings Program and Advance Payment Model,” CMS stated on its website. 

The Advance Payment ACO Model is open only to two types of organizations:

  • ACOs that do not include any inpatient facilities and have less than $50 million in total annual revenue.
  • ACOs in which the only inpatient facilities are critical access hospitals and/or Medicare low-volume rural hospitals and have less than $80 million in total annual revenue.

Applications to the Advance Payment Model are due September 19.