CMS announces first-year results from Pioneer ACO program

AHA News Now

Thirteen of the 32 Pioneer Accountable Care Organizations produced gross Medicare savings of $87.6 million in 2012, the first year of the program, while two shared in losses totaling about $4.0 million, the Centers for Medicare & Medicaid Services announced today. The Pioneer model tests a shared savings and shared losses payment arrangement, with higher levels of rewards and risks than in the Medicare Shared Savings Program. Costs for the more than 669,000 beneficiaries aligned to Pioneer ACOs grew by 0.3% in 2012, compared with 0.8% for other similar beneficiaries, CMS said. All Pioneer ACOs earned incentive payments for reporting quality measures, performing better overall on 15 clinical quality measures for which comparable fee-for-service data are available, the agency said. For example, 25 Pioneer ACOs generated lower risk-adjusted readmission rates for their aligned beneficiaries than the benchmark rate for all Medicare fee-for-service beneficiaries. Seven Pioneer ACOs that did not produce savings intend to apply to the Medicare Shared Savings Program, and two Pioneer ACOs intend to leave the program, CMS said. The agency expects to have first-year MSSP results later this year. 

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