The financial highs and lows of Pioneer ACOs

The trail blazed by Pioneer accountable care organizations (ACOs) is bumpier for some ACOs than for others, according to financial data released Thursday by the Centers for Medicare & Medicaid Services (CMS).

Of the 32 original Pioneer ACOs, 18 reported gross savings in the first year. The best-performing ACO that year was Montefiore ACO in the Bronx, New York, which reported savings of $23.3 million, or 7.1 percent, and $14 million in shared savings.

But 14 posted losses in the first year. The highest losses were posted by Fort Worth-based Plus! / North Texas ACO, with a loss of $9.31 million, or 5.2 percent.

The results "provide insight into why 12 of the ACOs exited the program," Becker's Hospital Review wrote.

Second-year results are more difficult to determine because three ACOs deferred reconciliation until the end of the third year, and nine dropped out of the program by that point. Since August, four more dropped out, leaving just 19 Pioneer ACOs.

Of those reporting second-year results, 14 posted savings while five reported losses. Montefiore again was the leader, reporting 7 percent in savings worth $24.6 million. Other top financial performers were Beth Israel Deaconess Health Care Organization in Boston, Arizona-based Banner Health Network and Steward Healthcare Network in Dedham, Massachusetts.

"(I)t seems clear that the Pioneer ACO program has serious problems," Healthcare Dive said, noting the ACO dropouts were unlikely to make money and some might have to return money to Medicare. "CMS doesn't seem to have a handle on what the Pioneer ACOs need, some ex-participants say."

CMS noted earlier this fall that Pioneer ACOs and Medicare Shared Savings Program ACOs saved more than $380 million in 2012.

For more information:
- here's the CMS data (.pdf)
- read the Becker'article
- check out the story by Healthcare Drive

 

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