CMS recently released the results of its Pioneer Accountable Care Organization Model's first performance year — all of the 32 original members were able to improve quality and together achieve $33 million in net savings for Medicare Trust Funds. But how did specific Pioneer ACOs do in their first performance year?
Here is a look at how 10 individual Pioneer ACOs fared, presented in alphabetical order.
1. Atrius Health
Newton, Mass.-based Atrius Health's first year as a Pioneer ACO showed mixed results — the organization was able to improve quality, but took a financial loss and will owe Medicare money, according to Gene Lindsey, MD, Atrius' president and CEO. Even though the ACO took a financial hit, Atrius plans to stay in the Pioneer program.
"We knew that we had a bigger challenge than some other Pioneers in our market given our initial costs, but we entered Pioneer with a view of this as a five-year program and made our investments to succeed over the long term," Dr. Lindsey said. "The initial data that we received from [the Center for Medicare and Medicaid Innovation] for 2013 indicates that we are on the right track financially and our quality data shows that we are substantially above the median on most measures. We will harvest these results as we move forward with this model to provide better care, better health and lower costs for our patients."
2. Banner Health Network
Phoenix-based Banner Health Network was able to save enough during its first performance year to generate shared savings of more than $13 million, according to a BHN news release. Officials credit the organization's care coordination, advanced population health technology and supportive case management efforts for the chronically ill.
"Through our experience, we believe the value-based Pioneer ACO model has merit, and that it has the potential to diminish the predominance of fee-for-service plans in government and private sectors," Chuck Lehn, CEO of Banner Health Network, said in a release. "It is the best solution at this time for creating sustainability for the Medicare program, and could be the basis for historic change in the U.S. healthcare industry."
BHN plans to remain in the Pioneer program and is recruiting additional physicians for 2014.
3. Beth Israel Deaconess Care Organization
The Beth Israel Deaconess Care Organization's Pioneer ACO in Boston was one of the 13 organizations to achieve enough savings to share in the savings with Medicare — the ACO saved 4.2 percent of its budget for patient care in 2012 and will receive $7.79 million in shared savings.
"These results demonstrate that BIDCO has succeed in creating an environment where physicians and hospitals are able to work collaboratively to achieve the triple aim…We know that the future will continue to demand more from us as a system, and we remain committed to furthering our efforts at innovation and partnerships for continued success," Christina Severin, BIDCO's president and CEO, said in a news release.
4. Dartmouth-Hitchcock
The Dartmouth-Hitchcock Pioneer ACO, based in Lebanon, N.H., met quality benchmarks in the Pioneer program and also generated savings — as a result, Dartmouth-Hitchcock will receive slightly more than $1 million in shared savings from Medicare.
"I'm encouraged that we're on the right track, and that we will continue to move closer to the goal of showing that we can successfully move away from fee-for-service payment models to a value-based model," Barbara Walters, DO, senior medical director for regional practices at Dartmouth-Hitchcock and leader of its Pioneer project, said in a news release.
5. Heritage California ACO
Northridge, Calif.-based Heritage Provider Network's Heritage California ACO had a successful first year as a Pioneer ACO and expects to continue improving quality and lowering the cost of care through care management programs, like case management and discharge planning.
"We are satisfied with the results and remain committed to the program," the ACO said in an emailed statement.
6. Montefiore Medical Center
Montefiore Medical Center's Pioneer ACO in New York City had the best financial performance of any Pioneer ACO in the first performance year. The ACO was able to save Medicare $23 million, meaning the organization will receive $14 million in shared savings.
"We are pleased to have been able to demonstrate to the nation that real change can happen with a vision, commitment and aligned financial incentives," Steven Safyer, MD, Montefiore Medical Center's president and CEO, said in a release. "Montefiore has been singularly focused on moving away from fragmented healthcare to more comprehensive care. Our success reflects our unique approach to healthcare and our strong partnerships with community physicians and other regional healthcare providers."
Montefiore's Pioneer ACO has more than 23,000 attributed beneficiaries.
7. OSF HealthCare
Peoria, Ill.-based OSF HealthCare's Pioneer ACO achieved some savings, but not enough to receive shared savings from Medicare.
"We are trending in the right direction in terms of better coordinating the care of our sickest patients, improving the quality of life while concurrently reducing the total cost of care for all of our Pioneer ACO patients by nearly 1 percent," Robert Sehring, chief ministry services officer for OSF Healthcare System said in a news release.
8. Partners HealthCare
Boston-based Partners HealthCare's Pioneer ACO was able to improve the quality of care provided to its 52,000 Medicare beneficiaries while lowering the cost of care. The ACO slowed the rate of cost growth by about 3 percent and will receive roughly $14.4 million in shared savings from Medicare as a result.
"As healthcare evolves in this country, we have an obligation to ensure that we deliver the best value possible to our patients and their families. These results show that it is possible to slow healthcare cost growth while delivering high-quality care," Gary Gottleib, MD, president and CEO of Partners HealthCare, said in a release. "We are confident that this Pioneer ACO initiative can provide a blueprint for the rest of the nation to follow," he added.
9. Steward Health Care System
Through improved clinical coordination and patient engagement, Steward Promise, the Pioneer ACO of Steward Health Care System in Boston, was able to achieve enough savings to share in them with Medicare, according to an emailed statement.
Steward developed some specific programs for its Pioneer ACO beneficiaries that helped improve quality and lower costs, according to an emailed statement. Some examples of those programs include pharmacists conducting home visits to beneficiaries after discharge to help them understand their medication and nurses and dieticians having regular contact to help patients make good lifestyle decisions.
10. University of Michigan Pioneer ACO
The University of Michigan Pioneer ACO in Ann Arbor achieved cost savings of 0.3 percent in 2012. However, the physician groups that comprise the Pioneer organization — the University of Michigan Medical School's Faculty Group Practice and the IHA physician group — plan to leave the Pioneer program and participate in a Medicare Shared Savings Program ACO instead.
"We remain firmly committed to the concept of improving healthcare and containing cost growth via the population health model that drives all ACOs," David Spahlinger, MD, executive director of the Faculty Group Practice, said in a news release. The physician groups plan to join the Physician Organization of Michigan ACO, an MSSP ACO formed earlier this year by the UM FGP and eight other physician groups around Michigan.