CMS selects thirty-two organizations to participate in Pioneer ACO Model
December 23, 2011
On Monday, December 19th, 2011 the Department of Health and Human Services (HHS) announced its list of 32 organizations that were selected to participate in the Pioneer Accountable Care Organization (ACO) Model, which begins January 1, 2012.
Launched by the CMS Innovation Center, the Pioneer ACO Model initiative will test the impact of different payment arrangements on helping organizations improve patient care and reduce Medicare costs. HHS estimates that this initiative could save up to $1.1 billion over five years.
Out of 80 applicants, 32 organizations were selected based on their experience offering coordinated patient-centered care, and for operating in an ACO-like manner. An ACO is a group of health care providers and suppliers that work together to deliver high-quality care and reduce costs.
A complete list of the organizations selected can be found in “Pioneer Accountable Care Organizations Model: General Fact Sheet.
During its first two years, the Pioneer ACO Model will test a shared savings and shared losses payment arrangement. The shared savings would be determined by comparison with CMS established benchmarks. In the third year, ACOs that showed savings over the first two years could move to a population-based per-beneficiary, per-month payment model.
CMS will determine which beneficiaries are aligned with each ACO. Generally, each ACO must have 15,000 beneficiaries, but those located in a rural area are allowed to have only 5,000. In addition, beneficiaries must be enrolled in original, fee-for-service Part A and Part B Medicare. To make sure beneficiaries receive high-quality care, CMS has set strict quality measures that it will monitor.
The Pioneer ACO Model is just one of several ACO initiatives. For more information on those programs, visit www.cms.gov/aco.