CMS Announces ACO Primary Care Flex Model

The Innovation Center at the Centers for Medicare & Medicaid Services (CMS) will test a new model beginning January 1, 2025, that aims to increase the number of low-revenue accountable care organizations (ACOs) in the Medicare Shared Savings Program (SSP). Participating ACOs will receive monthly prospective, primary care payments (PPCPs) from CMS to address the medical and health-related social needs of their patients.  The ACOs will distribute the PPCS to their primary care providers, which can include Federally Qualified Health Centers and Rural Health Clinics. CMS encourages distributing funds to providers on a capitated basis. ACO Primary Care Flex Model participants will also receive a one-time Advanced Shared Savings Payment to help cover the costs of forming an ACO and administrative costs associated with the model.  While this model features joint participation in both ACO Flex and the Medicare Shared Savings Program, ACO Flex participants will not be eligible to receive the SSP’s Advance Investment Payments.  CMS will host an hour-long public overview webinar on Thursday, April 4, at 2:00 pm Eastern. A Request for Applications is expected to be released in the second quarter of 2024. The initial submission period to apply to the SSP closes June 17, 2024.

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