Pioneer ACOs: Lessons learned from departing organizations

Despite the departure of the nine Pioneer accountable care organizations from the model program, two leading health experts are optimistic about the viability of the experiment based on the first-year results released by the Centers for Medicare & Medicaid earlier this month.

In a Health Affairs blog post, Debra Ness, president of the National Partnership for Women & Families, and Bill Kramer, executive director for national health policy at the Pacific Business Group on Health, wrote mixed results from the first year of testing the Pioneer ACOs was inevitable, but there is reason for hope:  

  • All 32 of the ACOs met quality performance metrics and performed well on cancer screenings, blood pressure control, cholesterol control for diabetes patients
  • Twenty-five of the 32 had success in reducing hospital readmission rates
  • More than a third reduced costs, producing cumulative savings of more than $87 million and saving Medicare nearly $33 million

"It is not surprising that some healthcare systems would re-evaluate their participation and choose to move on," Ness and Kramer wrote."The program does not guarantee it will be the right fit for every health system. That's the nature of innovation. And no model may be right for every population in every community."

But they said the departure of the nine ACOs offers two lessons:

  1. The imperative of patient- and family-centric care. ACOs will only succeed over the long term if they genuinely engage patients, families and consumers, in a comprehensive way, in both their design and their implementation, Ness and Kramer said. ACOs must be held accountable for patient- and family-centric measures such as patient-reported outcomes, care experience and care coordination. A strong foundation of primary care, also is essential to the "prevention, coordination and care management that produce better health outcomes, better care experience, more appropriate use of services, and lower cost," they said.
  2. The importance of patience. Americans far too often tend to look for a "magic bullet" that will permanently fix complex problems. If the new approach doesn't produce immediate results, we become disillusioned, Ness and Kramer wrote. "The ACO experiment deserves better," they said. "We think the Pioneer ACOs are on a promising track to realize better care and better value for our health care dollars. If these health systems increasingly become more patient- and family-centric, and strengthen their delivery of primary care, we will make progress," they wrote.

For more:
- here is the blog post
- read the CMS announcement about the Pioneer results

Suggested Articles

The profit margins and management of Community Health Group raise questions about oversight of managed care insurers.

Financial experts are warning practices about the pitfalls of promoting medical credit cards to their patients.

A proposed rule issued by HHS on Tuesday would expand short-term coverage, a move Seema Verma said will have "virtually no impact" on ACA premiums.