Pioneer ACOs have faced daunting obstacles on the trail to value-based care delivery. Nine of the inaugural participants have dropped out of the program, with several joining the less-demanding Medicare Shared Savings Program. MSSP allows providers to share value-based gains with Medicare, but they bear no risk of having to share the cost of falling short.
Providers Seek Pioneer ACO Fixes
With several accountable care hurdles cleared, and many more to come, CMS officials and healthcare providers are pondering new Pioneer ACO rules to smooth the road ahead in 2015. Earlier this year, CMS invited comments on new Pioneer ACO rules and the prospects for a second round of participant recruitment. "CMS is asking for ways to grow the program," Thompson says.
While acknowledging "there's still a lot of interest at hospitals and health systems," the AHA official said CMS needs to make changes to Pioneer ACO before a second round of participant recruitment is launched. "There's not this cry out there for every hospital to participate in an ACO," she says. "Pioneer ACO is just not a robust program from our perspective."
A letter the AHA sent to CMS on April 17 urges the federal agency to make changes to Pioneer ACO. Both the AHA and Pioneer ACO participants are seeking changes to the program's gainsharing mechanism.