CMS Posts Long-awaited Pioneer ACO Quality and Financial Results

CMS published for the first time the quality and financial performance for individual Pioneer accountable care organizations, a small, select group enlisted for Medicare’s most ambitious test of the payment model. First year financial results show health spending slowed as much as 7% among some ACOs and accelerated as much as 5% for others. In the second year, health spending slowed as much as 5.4% among those that reduced patients’ medical bills and accelerated as much as 5.6% where costs escalated.

Eight of the nine ACOs to walk away from the Pioneers in the first year reported an acceleration in health spending. Of those that dropped out, seven joined Medicare’s less risky ACO option, the Shared Savings Program. But the Pioneer ACO that reported the sharpest acceleration in health spending Plus! North Texas ACO dropped out entirely after costs grew 5.2% faster than projected.

Individual quality data was also released for the first year, when ACOs were required to provide performance scores but not required to meet targets for performance. Starting the second year, any financial payouts from savings are dependent on how well ACOs perform on quality.

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