Pioneer ACOs post mixed results, but providers still have faith in the model

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Mixed results from the first year of an ambitious accountable care organization program should not deter providers from moving toward coordinated care models, according to prominent observers.

All 32 of the Pioneer ACOs met quality measures in their first year and earned associated incentive payments, according to a July 16 report from the Centers for Medicare & Medicaid Services. However, only 13 lowered costs enough to share in Medicare savings, and nine will not participate in the second round. Two will drop out and seven will move into another ACO model, the Medicare Shared Savings Program. The Pioneer model offers higher rewards but poses greater financial risks to participants, which must pay back Medicare if they exceed spending benchmarks.

CMS characterized these results as “positive and promising.” While some observers were more circumspect, many agreed that despite some attrition from the Pioneer program, ACOs remain a viable new model for care delivery.

Greg Crist, spokesman for the American Health Care Association, confirmed that members of the nation's largest long-term care organization are “still exploring partnerships where it makes the most sense to be part of ACOs.”

Blair Childs, senior vice president of the Premier healthcare alliance, also stressed that providers should not be spooked by the Pioneer results.

“From the provider point of view, the Pioneer program is extremely ambitious, even for the most advanced health systems,” Childs stated. “Dropping from the Pioneer program does not mean that providers are abandoning their investments or wavering on the concept of ACOs.”

Long-term care providers that have not yet negotiated to join an ACO should act soon or they will be at disadvantage, according to John Durso, a McKnight's columnist and a partner and senior member of the Healthcare Practice Group at the law firm of Ungaretti & Harris LLP. He said ACOs and similar models of coordinated care are destined to replace the current U.S. healthcare system.

“Going it alone is not really viable today,” he said.

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