Next Generation ACOs performing well, but health IT challenges may hinder their success

Although Next Generation ACOs have performed well in their first year, health IT challenges like interoperability may be standing in their way of achieving greater success, according to a CMS evaluation prepared by NORC at the University of Chicago.

CMS launched the Next Generation ACO models in 2016 under the vision that providing strong financial incentives and adequate support tools would drive down costs for Medicare fee-for-service beneficiaries. The initial cohort comprised 18 NGACOs.

CMS data shows that the 2016 NGACOs generated $62 million in net savings to Medicare while maintaining quality of care, according to the report. In other words, the first cohort reduced its spending by approximately $100 million — a 1.7 percent decline — or a decrease of  $11.20 per beneficiary per month.

However, according to the report, disparate EHRs and lack of interoperability posed challenges for NCACOs. About half of the NGACOs are interacting with at least nine distinct EHR systems.  

"Many NGACOs explained that having multiple EHRs and lack of interoperability within their NGACO network prevent[s] effective information exchange for care coordination, quality improvement and performance improvement. In addition, consolidating and integrating data across multiple EHR platforms is a challenge," the report reads.

Several NGACOs also cited their providers' EHR capabilities as a limitation. "For example, while their EHR systems could produce registries, they could not distinguish levels of risk, identify high-cost patients, produce real-time reminders or track patients across a continuum," the report reads.

Nonetheless, CMS Administrator Seema Verma said in a prepared statement published alongside the report that "these results provide further evidence that ACOs succeed under two-sided risk."

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