The pioneer accountable care organization (ACO) model administered by the Centers for Medicare & Medicaid Services (CMS) Innovation Center has met quality performance metrics, but only some cost benchmarks. ACOs are groups of providers delivering coordinated care to improve patient outcomes and reduce costs. The pioneer ACO model enables providers with ACO or similar experience to move more quickly from a shared savings payment model to a population-based payment model, in which the provider accepts responsibility for the health of a group of patients in exchange for a set amount of money. The provider may then share in savings generated through efficient, quality care.
According to a July 16 announcement from CMS, all 32 pioneer ACOs improved quality performance and performed better than published rates in fee-for-service Medicare. However, only 13 Pioneer ACOs generated shared savings with Medicare, which amounted to a gross savings of $87.6 million. Seven of the Pioneer ACOs that did not generate savings will apply for the Medicare shared savings program, a more traditional ACO program with less risk.