CMS Releases Performance Results for Pioneer ACOs
CMS has released the quality and financial performance results for Medicare's individual Pioneer accountable care organizations, Modern Healthcare reports (Evans, Modern Healthcare, 10/8).
Background
Under the Pioneer program, which launched in January 2012, providers contract with CMS to meet quality targets and assume new risk when caring for a set population of Medicare beneficiaries. In exchange for adopting this risk, they receive additional financial incentives. So far, 13 of the 32 original ACOs have dropped out of the program (California Healthline, 9/26).
Financial Results
The first-year results included the performance of all 32 original Pioneer ACOs. Organizations that performed better than their benchmark and above the minimum savings rate shared some of the savings, while those that increased spending beyond their benchmark and their minimum loss rate helped cover the additional costs.
According to the report, health spending during the first year slowed by about 7% as a percentage of the organization's benchmark among some ACOs, while it increased by up to 5% for others (Modern Healthcare, 10/8). The ACOs that slowed spending the most in 2012 include:
- California-based Monarch HealthCare, which slowed spending by 6.3%, for which it received $6.07 million;
- Indiana-based Franciscan Alliance, which slowed spending by 6%, for which it received $6.67 million;
- New York City-based Montefiore ACO, which slowed spending by 7.1%, for which it received $14 million; and
- Northern California-based Brown & Toland Physicians, which slowed spending by 6%, for which it received $5.34 million.
Meanwhile, Plus!/North Texas ACO accelerated spending by 5.2% as a percentage of its benchmark, while Genesys PHO increased spending by $2.9% (Pioneer ACO financial results, October 2014).
The 2013 results, which include the performance of 20 ACOs, show that some Pioneer ACOs slowed spending by 5.4%, while others increased spending by up to 5.6% (Modern Healthcare, 10/8).
In 2013, Montefiore and Monarch again slowed spending relative to the organizations' benchmarks by the largest percentages -- by 7% and 5.4%, respectively. The next largest savings percentages included:
- Michigan Pioneer ACO, which slowed spending by 4.9%, for which it received $5.95 million; and
- Beth Israel Deaconess Care Organization, which slowed spending by 3.9%, for which it received $10.6 million.
Meanwhile, the largest increase in spending during 2013 came from Beacon Health, which accelerated spending by 5.6% and therefore owed $2.89 million (Pioneer ACO financial results, October 2014).
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