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Thursday, July 25, 2013

Not All Pioneer ACOs Have Found Success

by Nathaniel Weixel

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After a year of participation, the results of the first 32 Pioneer accountable care organizations are in, and they’re decidedly mixed. According to the Centers for Medicare & Medicaid Services, all 32 Pioneers succeeded in meeting quality measures for the first performance year, with all earning incentive payments for their reporting accomplishments.

But in order to fully share in savings, Pioneer ACOs also had to lower their costs against benchmark amounts, which proved much more difficult, as only 13 of them succeeded. Two Pioneers overspent so much that they will wind up owing Medicare over $4 million between them. Nine of the Pioneers said they won’t be participating in the second year of the program; seven will be applying to the more traditional Medicare Shared Savings Program (which requires much less risk than the Pioneer program), while two said they will be dropping out altogether.

Pioneer ACOs signed up for a three year contract, so those that succeeded in the first year of the program will be re-evaluated next year. However, stakeholder groups like the Premier healthcare alliance and the American Medical Group Association said that successful or not, all the Pioneers should be applauded as trailblazers in the first wave of delivery system reform.
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