Two years after the Centers for Medicare & Medicaid Services (CMS) launched its Pioneer Accountable Care Organization (ACO) model, the initiative is now down to about 60% of its original participants following the exit of three health systems last week.
The latest ACOs to leave the CMS program—Franciscan Alliance in Indianapolis; Genesys PHO in Flint, Mich. and Renaissance Health Network in Wayne, Pa.—brings the total number of participating organizations involved to 19 ACOs, reported Modern Healthcare.
In 2011, CMS selected 32 ACOs to participate in its Pioneer ACO Model. Administered by the CMS Innovation Center, the Pioneer program was designed to enable provider groups to move more rapidly from a shared savings payment model to a population-based payment model consistent with the Medicare Shared Services Program.
Under the Shared Savings Program, ACOs are provided incentives to meet standards for quality performance and efforts in reducing costs to Medicare. However, the exit of 13 health systems from the Pioneer program to date has stirred concerns that even sophisticated organizations may be unwilling to take losses while they wait for policymakers to test new payment and healthcare delivery models.
Most recently, Sharp HealthCare in San Diego announced its decision to pull out of the CMS program after determining “the model was financially detrimental” despite the ACO’s performance managing quality and healthcare use, according to MH.
CMS, on the other hand, suggests the model has helped ACOs in the Pioneer initiative generate over $372 million in total program savings, according to data from the U.S. Department of Health & Human Services.
As for the newest round of exiting ACOs, the reasons for leaving the program varied from not sharing any savings in the Pioneer program’s second year, to the program failing to adjust for socio-economic factors and the severity of patients’ health in certain local populations.
Read more at Modern Healthcare.
Written by Jason Oliva