Plus ACO began with approximately 19,000 patients in the first year and grew to almost double that in the second year. It is on pace to save $10 million annually in the first two years of the Pioneer program, Watson says, but the ACO anticipated that with down-side risk in the third year it could be liable for a penalty of between $6 million and $9 million.
"Pioneer ACOs have the option to drop out of the program with no penalty at this point in time. We're at a decision point where we must opt-in or opt-out," Watson added.
Although Plus ACO will cease to exist, Texas Health Resources appears committed to ACOs. It has a commercial ACO with Aetna and is in talks with other commercial payers about ACO arrangements. In addition to Plus ACO, Albuquerque-based Presbyterian Healthcare Services has also confirmed its mid-August departure from the Pioneer ACO program.
In a press statement, Presbyterian Healthcare Services officials said that the integrated delivery system will focus its efforts on its accountable care model of managing the risk of its health plan members and in developing partnerships with employer groups. "The Pioneer ACO population of 12,000 was very small compared to our Medicare Advantage population of 36,400 and the nearly 300,000 lives we manage under full risk contracts."