9 ACOs dump Medicare’s Pioneer program

August 9, 2013

Medicare’s Pioneer Accountable Care Organization (ACO) program lost two organizations that suffered $4 million in losses, while seven others have shifted to a less financially stringent ACO model.

Medicare’s Pioneer Accountable Care Organization (ACO) program lost two organizations that suffered $4 million in losses, while seven others have shifted to a less financially stringent ACO model.

Those seven organizations plan to move to the Medicare Shared Savings Program, which permits bonus-only financial arrangements, according to the Centers for Medicare and Medicaid Services (CMS).

While all of the Pioneer ACOs beat industry benchmarks for their first year, only 13 made enough to share the savings with CMS.

CMS views it as a win.

Overall, the results included higher quality care and lower Medicare expenditures. And the costs for about 669,000 beneficiaries aligned to Pioneer ACOs grew by only 0.3% in 2012, while costs for similar beneficiaries grew by 0.8%. 

“The Affordable Care Act has given us a wide range of tools to realign payment incentives in Medicare and Medicaid,” says CMS Administrator Marilyn Tavenner. “These efforts are already paying off.”

The central premise of the Pioneer ACO model is to realign payment incentives, while promoting high-quality and coordinated care for the highest level of wellness for Medicare beneficiaries.