Washington, D.C.-based news outlet The Hill has obtained a leaked copy of the confidential draft proposal for Pioneer Accountable Care Organizations, which contains the calculations and methodologies used to define the program.
The 43-page draft indicates that, under the proposed model, Medicare beneficiaries will remain free to select providers and services of their choice. ACOs may also elect to cap the expenditures of certain beneficiaries to reduce the impact of those who "incur extraordinary claims on the average performance year expenditure of the ACO-aligned population," according to the draft.
The draft also contains proposed savings and benchmark calculations, along with the methodology for the national reference population of all ACO-alignment-eligible beneficiaries.
Read the draft proposal for Pioneer ACOs here (pdf).
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The 43-page draft indicates that, under the proposed model, Medicare beneficiaries will remain free to select providers and services of their choice. ACOs may also elect to cap the expenditures of certain beneficiaries to reduce the impact of those who "incur extraordinary claims on the average performance year expenditure of the ACO-aligned population," according to the draft.
The draft also contains proposed savings and benchmark calculations, along with the methodology for the national reference population of all ACO-alignment-eligible beneficiaries.
Read the draft proposal for Pioneer ACOs here (pdf).
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