Pioneer Accountable Care Organizations (ACOs) that were set up under the Affordable Care Act produced higher quality and lower Medicare expenditures during their first performance year, according to the Centers for Medicare & Medicaid Services (CMS). Their performance during 2012 was compared to costs for similar beneficiaries not in ACOs and to established quality benchmarks.
Pioneer ACOs are made up of providers already experienced in coordinated care and ACO-like arrangements. Providers share in a greater percentage of financial savings, but also share in any financial losses.
According to CMS:
- Costs for the 669,000 beneficiaries in Pioneer ACOs grew by 0.3 percent in 2012, compared to 0.8 percent for non-ACO beneficiaries.
- 13 out of 32 Pioneer ACOs produced gross savings of $87.6 million, while 2 suffered losses totaling about $4 million.
- Overall, Pioneer ACOs performed better on all 15 clinical quality measures for which comparable data are available in fee-for-service Medicare.
- 25 of 32 Pioneer ACOs generated lower readmission rates for their beneficiaries than the benchmark for all Medicare fee-for-service beneficiaries.
CMS said that 7 Pioneer ACOS that did not produce savings will apply to the Medicare Shared Savings Program, another ACO model that does not require providers to share in financial losses. Also, 2 pioneer ACOs intend to leave the ACO program entirely.