CMS clarifies pioneer ACO model, extends application dates

While the comment period for the proposed rules of the Medicare Shared Savings Program closed yesterday, the Centers for Medicare & Medicaid today clarified the Pioneer Accountable Care Organization (ACO) Model. Separate from the Medicare Shared Savings Program, the CMS Innovation Center is offering the Pioneer ACO Model for more experienced organizations and providers who already coordinate care across multiple settings so they can reap the rewards earlier than Shared Savings participants.

The goal is to test how experienced organizations coordinate care with private payers to improve outcomes of Medicare beneficiaries; those practices may later be included in the Shared Savings Program.

CMS stressed the benefits of participating in the Pioneer ACO model, including a longer three-year commitment period with the option to extend to five years. In addition, participants who will experience more risk can also receive more rewards compared to the Shared Savings Program.

CMS extended application deadlines in response to providers who voiced concerns so that they now may have more time to put together a stronger application and gain organizational support. CMS extended the deadline for the required letter of intent by two weeks for a new due date of June 30. The letter of intent is nonbinding and will not be published online. CMS also extended the application deadline by a month for a new due date of August 19.

ACOs participating in the Pioneer Model cannot later participate in the Shared Savings Program.

For more:
- read the CMS Pioneer ACO Model fact sheet (.pdf)
- check out the CMS fact sheet on beneficiary protections, data sharing and quality (.pdf)
- read the FAQs on ACOs
- learn about the letter of intent and application forms

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