Pioneer ACO Model Offers Participants Flexibility

Margaret Dick Tocknell, for HealthLeaders Media , December 20, 2011

"Pioneer ACOs are leaders in our work to provide better care and reduce health care costs," said Kathleen Sebelius, HHS secretary, at the press conference held to announce the Pioneer ACOs. "We are excited that so many innovative systems are participating in this exciting initiative—and there are many other ways that health care providers can get involved and help improve care for patients."

The Pioneer ACO model will test a shared savings and shared losses payment arrangement with higher levels of reward and risk than in the ACO shared savings program. In year three of the program, Pioneer ACOs that have shown savings over the first two years will be eligible to move to a population-based payment model that is intended to replace some or all of the ACO's fee-for-service payments with a monthly payment.

The contracts require that more than 50% of all patients in an ACO move to global payment–type contracts by the third year.

Gene Lindsey, CEO of Atrius Health, said his physician groups looked at the shared savings ACO but like the Pioneer model better because it is more focused. Atrius Health will begin with 26,000 participating ACO patients and expects to grow that number to 40,000 participants within three years. His group hopes to leverage what it learns in the Medicare program to develop a commercial ACO.

Five groups in the Boston area were named Pioneer ACOs. Lindsey believes that public acceptance of the ACO concept will be higher as a result, adding, "I expect we'll share information, especially best practices, and develop learning collaboratives."

The first performance period for Pioneer ACOs will begin Jan. 1, 2012.

Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.

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