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Six Calif. Entities Are ‘Pioneer’ Accountable Care Organizations

On Monday, six California entities were among 32 health care organizations nationwide that were selected to participate in the "Pioneer" accountable care organization initiative, Kaiser Health News/Washington Post reports (Torres, Kaiser Health News/Washington Post, 12/19).

Background

The Pioneer ACO program is designed to reward early adopters of coordinated care models, the AP/San Francisco Chronicle reports (AP/San Francisco Chronicle, 12/19). HHS received about 80 applications for the program. The complete list of organizations selected for the Pioneer program is available on CMS' website.

According to an HHS release, the program aims to foster collaboration among primary care physicians, hospitals and other health care professionals to improve care for Medicare patients. The department estimates that it could save up to $1.1 billion over five years.

Specifically, the initiative will test the effectiveness of innovative payment models and how they help organizations improve care quality, reduce costs and coordinate services with private payers (Kaiser Health News/Washington Post, 12/19). The first performance period will begin on Jan. 1.

Selected Organizations

The organizations selected for the program span 18 states and care for approximately 860,000 Medicare beneficiaries (Sanger-Katz, National Journal, 12/19).

They all have made progress toward or already are functioning as ACOs and will serve as a guide for the groups expected to apply for a larger Medicare Shared Savings Program that is set to launch next year (Kaiser Health News/Washington Post, 12/19).

Acting CMS Administrator Marilyn Tavenner said the program will help health care organizations experiment with ways to achieve better care and lower spending. She said, "We know that health care providers are at different stages in their work to improve care and reduce costs," adding, "That's why we've developed a menu of options for Medicare to meet doctors, hospitals and other health care providers where they are, and begin the conversation of how to enhance the care they are offering to people with Medicare."

HHS Secretary Kathleen Sebelius added that "[p]ioneer ACOs are leaders in our work to provide better care and reduce health care costs" (HHS release, 12/19).

California Organizations

The six California organizations selected to take part in the Pioneer ACO initiative are:

  • Brown & Toland Physicians, based in San Francisco;
  • HealthCare Partners Medical Group, which serves Los Angeles and Orange counties;
  • Heritage California ACO, which serves southern, central and coastal California;
  • Monarch HealthCare, based in Orange County;
  • PrimeCare Medical Network, which serves Riverside and San Bernardino counties; and
  • Sharp HealthCare System, based in San Diego (California Association of Physician Groups release, 12/19).
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