Industry News

CMS Announces the Success of the Pioneer ACO Model.

Jennifer Kirchner | July 2013

The Centers for Medicare & Medicaid Services (CMS) recently announced the success of the first year of the Pioneer Accountable Care Organization (ACO) Model (Model).  The Pioneer ACO Model, launched by the CMS Innovation Center and created by the Patient Protection and Affordable Care Act, encourages coordinated care for Medicare beneficiaries by providers and caregivers.  The Model demonstrated improving costs for 13 of the 32 Pioneer ACOs.  Specifically, costs grew by only 0.3 percent in 2012 for nearly 700,000 beneficiaries aligned to the Pioneer ACOs, where costs for general Medicare beneficiaries grew by 0.8 percent in the same period.  Pioneer ACO beneficiaries also received greater quality care improvements compared to the general Medicare population including lower risk-adjusted readmission rates and better performance on quality clinical measures for hypertension control and low density lipoprotein control for patients with diabetes.  ACO beneficiaries also rated Pioneer ACOs higher on all four patient experience measures relative to the 2011 Medicare fee-for-service results.

The press release announcing the success of the Pioneer ACO Model is available at:

http://cms.gov/Newsroom/MediaReleaseDatabase/Press-Releases/2013-Press-Releases-Items/2013-07-16.html.

 Centers for Medicare & Medicaid Services.  “Pioneer Accountable Care Organizations Succeed in Improving Care, Lowering Costs.”  Press Release.  16 Jul. 2013.

About the Author

Jennifer Kirchner is a licensed attorney in Illinois and Wisconsin. Ms. Kirchner has expertise in assessing provider compliance with the Anti-Kickback Statute, Stark Law, the False Claims Act, HIPAA Privacy and Security Rules and clinical research laws and regulations.