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Pioneer ACO model attracts 32 healthcare providers

December 19, 2011
by Kevin Kolus
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Thirty-two healthcare organizations from 18 states are participating in the government’s Pioneer Accountable Care Organizations (ACOs) initiative, the Department of Health and Human Services announced Monday.

The Pioneer ACO initiative will reward primary care doctors, specialists, hospitals and other caregivers for providing higher quality, coordinated care for people with Medicare. According to the HHS announcement, the 32 participating organizations could save Medicare up to $1.1 billion over five years.

Under the Pioneer ACO model, which is operated by the Centers for Medicare & Medicaid Services (CMS) Innovation Center, Medicare will reward ACOs based on how well they are able to improve the health of their Medicare patients and lower their healthcare costs.

The Pioneer ACO model, originally announced in May 2011, is designed specifically for advanced groups of providers with experience in coordinating patient care. The 32 Pioneer ACOs underwent a “rigorous competitive selection process,” according to HHS, which included an extensive review of applications and in-person interviews.

“The initiative will test the effectiveness of several innovative payment models and how they can help experienced organizations to provide better care for beneficiaries, work in coordination with private payers and reduce Medicare cost growth,” HHS said. “These payment models will allow organizations that are successful in achieving better care and lower cost growth to move away from a payment system based on volume under the fee-for-service model, towards one where the ACO is paid based on the value of care it provides.”

Pioneer ACOs will be held financially accountable for the quality of patient care and the health of their aligned populations. CMS has established quality measures by which ACOs will be judged to track patient care and health, and are identical to the quality measures in place for the Medicare Shared Savings Program

The first performance period of the Pioneer ACO Model begins January 1, 2012.

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