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Pioneer ACOs See Millions in Savings, Higher Quality Scores

Nearly half of Pioneer Accountable Care Organizations (ACOs) earned shared savings in 2012 and 2013, according to a report by the U.S. Government Accountability Office (GAO). Approximately 48 percent of participating ACOs produced $121 million in total shared savings in 2013, with a net shared savings of $99 million. The ACOs themselves received $68 million of the achieved savings.

This is a decrease in net savings from the initial year of testing in 2012, when 41 percent of participating ACOs produced $139 million in total shared savings with a net shared savings of $134 million. Participating ACOs received $77 million of those savings. Despite decreased savings in the second year of testing, GAO found that ACOs participating in both 2012 and 2013 had higher quality scores in the second year of participation.

ACO models, as part of the Medicare Shared Savings Program, allow eligible providers to share savings with Medicare when they demonstrate efficient care delivery and meet quality performance benchmarks. The Pioneer ACO Model was designed for providers experienced in coordinating care across care settings to work toward population-based payment models. These providers generally see higher levels of sharing and risk than those participating in other shared savings programs.

The Centers for Medicare & Medicaid Services recently announced that the Pioneer ACO Model will be the first alternative payment model expanded beyond a pilot program to a larger population of Medicare beneficiaries. ACOs will continue to be a mechanism to meet the U.S. Department of Health and Human Services’ goal of tying 30 percent of Medicare payments to quality- and value-based alternative payment models by 2016 and 50 percent by 2018.

Contact Beth Feldpush, DrPH, senior vice president of policy and advocacy, at bfeldpush@essentialhospitals.org or 202.585.0111 with questions.

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About the Author

Matt Buechner is the policy and advocacy associate for America's Essential Hospitals.

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