CMS Reports Pioneer ACO Saving Money Despite Rough Start
Overcoming the loss of nine participants last year, CMS reports the Pioneer ACO Program saved nearly $150 million, provided high-quality care
According to CMS, “The Pioneer ACO Model is designed for health care organizations and providers that are already experienced in coordinating care for patients across care settings. It will allow these provider groups to move more rapidly from a shared savings payment model to a population-based payment model on a track consistent with, but separate from, the Medicare Shared Services Program. And it is designed to work in coordination with private payers by aligning provider incentives, which will improve quality and health outcomes for patients across the ACO, and achieve cost savings for Medicare, employers and patients”
Now, after surviving the defection of 9 of its 32 hospitals and health systems, CMS is reporting “Pioneer ACOs generated gross savings of $147 million in their first year while continuing to deliver high quality care. Results showed that … nine had significantly lower spending growth relative to Medicare fee for service while exceeding quality reporting requirements. These savings far exceed findings from a previous analysis conducted by CMS, which used a different methodology.
“’We are still early on in the program, but are encouraged by these results and are on track to meet our goals for participation in the Pioneer Accountable Care Organization Model”, said Dr. Barbara Walters, executive medical director for accountable care, with the Dartmouth-Hitchcock ACO. “Our strategies of using patient outreach and education and regular follow up for targeted chronic disease programs are allowing us to anticipate patient needs before their health problems become worse. Involvement in the Pioneer Model is helping us provide better treatment for our patients across a wide-range of health challenges.’”
HHS Secretary Kathleen Sebelius was encouraged by the results, stating, "Today's findings demonstrate that organizations of various sizes and structures across the country are working with their physicians and engaging with patients to better coordinate and deliver high quality care while reducing expenditure growth."
Montefiore Medical Center, a Pioneer member, reports in a press release it “generated substantial savings for the Medicare program, representing the highest financial performance among all Pioneer ACOs. Data also showed that monthly Medicare spending per beneficiary among Montefiore ACO participants represented a savings of $104 compared to monthly spending per beneficiary among a local market comparison group.”
The release notes, “Savings were achieved through increased patient engagement, care coordination and preventative, patient-centered care provided wherever needed – in the hospital, in doctors' offices, by phone and at home. Innovative nurse-driven interventions supported patient outcomes and experience. Through a unique collaboration with physicians in the community and across Montefiore's healthcare system, Montefiore ensured clinical excellence at all points of care.”
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