Is the government’s Pioneer ACO program in trouble? CMS released data from the program's first two years.
Is the government’s Pioneer accountable care organization (ACO) program in trouble?
The Pioneer program consists of a select group of providers “already experienced in coordinating care for patients across care settings,” according to the Centers for Medicare and Medicaid services (CMS). But the results from the program’s first two years, 2012 and 2013, remain mixed as ACOs unable to achieve shared savings continue to drop out, CMS data shows.
Results from the first two years of the program show that some of the participating ACOs have saved money, while others have actually increased their costs. Meanwhile, participants in the program continue to drop out, including three in September, thinning the ranks from 32 organizations to 19. One of the recent dropouts called the Pioneer ACO program “financially detrimental.”
According to the CMS data, half of the 32 original participants had either no savings or recorded losses. The best performing ACO saved about $23 million, or 7% of the ACO’s expected expenditures based on benchmarks. The ACO with the largest losses recorded more than $9.3 million in losses, or about 5% of expected costs. Typically, the average spending was about $20 less per month per Medicare beneficiary compared to if the ACO had not participated in the Pioneer program.
The second year saw mixed results as well. Of the 20 ACOs that released results, six lost money while 14 realized savings. Nine were no longer participating and three deferred releasing results until after the third year of the program.
In September, U.S. Health and Human Services Director Sylvia Burwell said that providers using the ACO model have saved Medicare more than $372 million.