19. December 2011 · Comments Off · Categories: Health Law · Tags: , ,

Thirty two (that’s 32, count’em) organizations have been selected by the Center for Medicaid and Medicare Services to participate in the Pioneer ACO program. In its May 2011 announcement about the prgram, CMS had stated that to be “eligible to participate in the Pioneer ACO Model, organizations would ideally already be coordinating care for a significant portion of patients under financial risk sharing contracts and be positioned to transform both their care and financial models from fee-for-service to a three-part value based model.”


CMS provided additional description of the Pioneer model last year: 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 Savings 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.


So, these 32 organizations are not the ones who have applied for, or who may apply for, the other major ACO program, the Medicare Shared Savings Program.  These 32 are described by CMS as being seasoned organizations who already have experience in coordinating care for patients across care settings. 


Given this experience, the “pioneer model” of ACO’s may make sense for these particular organizations, although I would characterize the entire group as “experienced pioneers” and not “newbies in the woods.”