The Pioneer Accountable Care Organization (ACO) Model will be the first alternative payment model expanded beyond a pilot program to a larger population of Medicare beneficiaries. The U.S. Department of Health and Human Services (HHS) estimates that the Pioneer ACO Model saved approximately $300 per patient per year, accounting for more than $384 million in savings during its 2012 to 2013 pilot phase. This is part of a combined savings of more than $417 million from all of the Medicare Shared Savings Program ACO models. ACOs will continue to be a mechanism to meet HHS’ goal of tying 30 percent of Medicare payments to quality- and value-based alternative payment models by 2016 and 50 percent by 2018.
ACO models allow eligible providers to share savings with Medicare when they demonstrate efficient care delivery and meet quality performance benchmarks. Providers may also be required to pay a share of any losses to Medicare. The Pioneer ACO Model was designed for providers experienced in coordinating care across care settings to work toward population-based payment models. Providers participating in the Pioneer ACO Model generally see higher levels of sharing and risk than those participating in other shared savings programs.
Contact Beth Feldpush, DrPH, senior vice president of policy and advocacy, at email@example.com or 202.585.0111 with questions.