The Centers for Medicare & Medicaid Services (CMS) announced positive results from the first performance year of the Pioneer Accountable Care Organization (ACO) Model. The Pioneer ACO Model encourages providers and caregivers to deliver more coordinated care for Medicare beneficiaries. This model, launched by the CMS Innovation Center, is part of the Affordable Care Act’s efforts to realign payment incentives, promoting high-quality, efficient care for Medicare beneficiaries.
According to CMS, costs for the more than 669,000 beneficiaries aligned to pioneer ACOs grew by 0.3 percent in 2012 where as costs for similar beneficiaries grew by 0.8 percent in the same period. Thirteen out of 32 pioneer ACOs produced shared savings with CMS, generating a gross savings of $87.6 million in 2012. Pioneer ACOs earned more than $76 million by providing coordinated, quality care. Only two pioneer ACOs had shared losses totaling about $4 million. Program savings were driven, in part, by reductions that pioneer ACOs generated in hospital admissions and readmissions.
CMS further stated that all 32 pioneer ACOs successfully reported quality measures and achieved the maximum reporting rate for the first performance year, with all earning incentive payments for their reporting accomplishments. Overall, pioneer ACOs performed better than published rates in fee-for-service Medicare for all 15 clinical quality measures for which comparable data are available, such as readmissions, blood pressure control, and cholesterol control for patients with diabetes. Seven measures had no comparable data in the published literature. In addition, pioneer ACOs were rated higher by ACO beneficiaries on all four patient experience measures relative to the 2011 Medicare fee-for-service results.
For more information on the ACO’s quality measures and reporting standards, visit the CMS Shared Savings Program webpage.
