Three More ACOs Announce Departure From Pioneer Program
Three additional accountable care organizations have dropped out of Medicare's Pioneer ACO program, bringing a program that started with 32 elite organizations down to 19 remaining ACOs, Modern Healthcare reports. At least two of the three organizations plan to apply to join the Medicare Shared Savings Program (Evans, Modern Healthcare, 9/25).
Background on Pioneer ACO Program
The Pioneer program is one of the Affordable Care Act's signature initiatives aimed at producing better care at a lower cost.
Under the Pioneer program, which launched in January 2012, participating providers contract with CMS to meet quality targets and assume new risk when caring for a set population of Medicare beneficiaries.
All 32 ACOs in the program improved the quality of patient care in the first year of the program, but only about one-third lowered costs by enough to generate shared savings, according to data released in 2013.
In July 2013, nine ACOs pulled out of the Pioneer program -- including two in California:
- HealthCare Partners ACO California; and
Details of Latest ACOs To Drop Out
The three latest Pioneer ACOs to drop out of the program are:
- Franciscan Alliance in Indianapolis and Central Indiana;
- Genesys PHO in Southeastern Michigan; and
- Renaissance Health Network in Southeastern Pennsylvania.
The ACOs' exit from the program means a total of 13 ACOs have dropped out of the program to date.
The ACOs announced their decisions one week after CMS reported on the financial performance of Pioneer ACOs in the program's second year. According to the agency, 11 participants qualified for $68 million in shared savings in the year two.
Franciscan Alliance plans to move into MSSP, according to Franciscan Alliance Accountable Care Organization Regional Vice President Jennifer Westfall. The ACO did not receive any bonus payments in the program's second year, and it did not expect to receive a bonus in the third year either (Modern Healthcare, 9/25).
"Overall, our Pioneer ACO received a quality score rating of 83.7%. While this is indicative of strong performance, we did not do as well in meeting our benchmark for reducing the costs of patient care," Westfall says (Leventhal/Hagland, Healthcare Informatics, 9/25).
Meanwhile, Genesys PHO President and CEO Michael James said his organization also plans to join MSSP. He added that the Pioneer model put the ACO at a disadvantage. Genesys PHO received a $2.5 million penalty in the program's first year and a $1.9 million penalty in the program's second year (Modern Healthcare, 9/25).
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