Following several high-profile exits from the Pioneer Accountable Care Organization program, the Centers for Medicare & Medicaid Services thought its newer “Next Generation” model would resolve the problems that led to the ACOs giving up on the shared savings program. Apparently that may not be the case because three Next Generation ACOs have announced they will leave the program.
Harrisburg, Pennsylvania-based RiverHealth and Raleigh, North Carolina’s WakeMed Key Community Care both announced their withdrawals from the program, citing difficulty achieving the cost targets set by CMS, according to Healthcare Finance News. However, WakeMed officials said the system is assessing whether it can participate in Medicare ACOs in 2017.
Meanwhile, Heritage Provider Network will scale back its participation for the remainder of the calendar year but plans to fully participate next year, Healthcare Finance News reported.
The exits leave the program with 18 participants and next month CMS plans to announce participants for 2017.
Participants in the Next Generation model take on more financial risk with the potential to obtain a greater reward. The program was meant to help propel the industry toward a value-based payment system.
Despite high hopes for the model, the ACOs’ reasons for leaving the shared savings model echo many of those cited by former Pioneer participants. Mount Auburn Hospital left the Pioneer program due to projected financial losses even amid $14 million in savings. Massachusetts’ Steward Health Care System, despite saving $30 million in the Pioneer program, announced it wouldl switch to the Next Generation program due to what leaders perceived as an opportunity for better financial performances, FierceHealthcare previously reported.