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Second Opinion

Learn about policy issues important to medical schools and teaching hospitals, with Executive Vice President Atul Grover, M.D., Ph.D.

Washington Highlights

CMS Announces Results From First Year of Pioneer ACO Model

July 19, 2013—The Centers for Medicare and Medicaid Services (CMS) July 17 announced results from the first Pioneer Accountable Care Organization (ACO) performance year.  The Pioneer ACO, launched through the CMS Center for Medicare and Medicaid Innovation (CMMI), was designed to allow provider groups to move more rapidly from a shared savings payment model to a population-based payment model while working in coordination with private payers.  Pioneer ACO participants were selected in late 2011, and included 12 AAMC members [see Washington Highlights Dec. 22, 2011].

Thirteen of the 32 Pioneer ACOs produced shared savings in the first performance year, generating a gross savings of $87.6 million in 2012.  Costs for the more than 669,000 beneficiaries aligned to Pioneer ACOs grew by only 0.3 percent in 2012, whereas costs for similar beneficiaries grew by 0.8 percent in the same period.

All 32 Pioneer ACOs successfully reported quality measures and achieved the maximum reporting rate for the first performance year, earning incentive payments for their reporting. Pioneer ACOs performed better than published rates in fee-for-service Medicare for all 15 clinical quality measures for which comparable data are available.  Examples of the Pioneer ACOs’ quality achievements include lower risk-adjusted readmission rates and better control of hypertension and cholesterol.

Despite overall positive performance, seven Pioneer ACOs that did not produce savings have notified CMS that they intend to apply to the Medicare Shared Savings Program (MSSP), and two Pioneer ACOs have notified CMS of their intent to leave the program.

CMS anticipates having MSSP first year results later this year.

Contact:

Jane Eilbacher
Policy and Regulatory Specialist
Telephone: 202-828-0896
Email: jeilbacher@aamc.org

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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.


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For More Information

Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806
Email: jkleinman@aamc.org