CMS extends application deadlines for Pioneer ACO model

July 6, 2011

The Centers for Medicare & Medicaid Services (CMS) gave organizations interested in participating in the Pioneer ACO model a little longer to circle their wagons. Responding to concerns from provider organizations that there was insufficient time to assemble internal support and strong applications, CMS extended the deadline for applications to August 19 for those who submitted their letters of application by an extended June 30 deadline.

The Centers for Medicare and Medicaid Services (CMS) gave organizations interested in participating in the Pioneer ACO (Accountable Care Organization) model a little longer to circle their wagons.

Responding to concerns from provider organizations that there was insufficient time to assemble internal support and strong applications, CMS extended the deadline for applications to August 19 for those who submitted their letters of intent by an extended June 30 deadline.

Designed for more advanced organizations that have “experience in delivering care across setting[s] for defined population of patients as well as managing financial risk,” according to a CMS Open Door Forum conference call held in June, the Pioneer program was announced in mid-May. Letters of intent were initially due June 10 and applications on July 18.

Participants in the Pioneer ACO model contract with CMS for 3 years, with an option to extend to 5 years and assume higher risk in exchange for potentially greater reward. In addition, the payment arrangement moves toward population-based payment rather than fee-for-service in the third year.

Participants are expected to structure similar payment arrangements with commercial insurers and other payers so that at the end of year two of the contract with CMS, the majority of a Pioneer ACO’s total revenues will come from outcome-based contracts.

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