Pioneer ACO Model

Overview

The Pioneer ACO Model is designed for health care organizations and providers that are already experienced in coordinating care for patients across care settings. It will allow these provider groups to move more rapidly from a shared savings payment model to a population-based payment model on a track consistent with, but separate from, the Medicare Shared Savings Program. And it is designed to work in coordination with private payers by aligning provider incentives, which will improve quality and health outcomes for patients across the ACO, and achieve cost savings for Medicare, employers and patients.

 

The Pioneer ACOs

Pioneer ACOs mapped. Data is duplicated in the text below.

There are 32 ACOs participating in the Pioneer ACO Model.

 
  • Allina Health (Minnesota and Western Wisconsin)
  • Atrius Health (Eastern and Central Massachusetts)
  • Banner Health Network (Phoenix, Arizona Metropolitan Area Maricopa and Pinal Counties)
  • Beacon Health (Central, Eastern, and Northern Maine)
  • Bellin Thedacare Healthcare Partners (Northeast Wisconsin)
  • Beth Israel Deaconess Physician Organization (Eastern Massachusetts)
  • Brown & Toland Physicians (San Francisco Bay Area, California)
  • Dartmouth-Hitchcock ACO (New Hampshire and Eastern Vermont)
  • Fairview Health Systems (Minneapolis, MN Metropolitan Area)
  • Franciscan Alliance (Indianapolis and Central Indiana)
  • Genesys PHO (Southeastern Michigan)
  • Healthcare Partners Medical Group (Los Angeles and Orange Counties, California)
  • Healthcare Partners of Nevada (Clark and Nye Counties, Nevada)
  • Heritage California ACO (Southern, Central, and Costal California)
  • JSA Medical Group, a division of HealthCare Partners (Orlando, Tampa Bay, and surrounding South Florida)
  • Michigan Pioneer ACO   (Southeastern Michigan)
  • Monarch Healthcare (Orange County, California)
  • Montefiore ACO (New York City (the Bronx) and lower Westchester County, New York)
  • Mount Auburn Cambridge Independent Practice Association (MACIPA) (Eastern Massachusetts)
  • OSF Healthcare System (Central Illinois)
  • Park Nicollet Health Services (Minneapolis, Minnesota Metropolitan Area)
  • Partners Healthcare (Eastern Massachusetts)
  • Physician Health Partners (Denver, Colorado Metropolitan Area)
  • Plus (Tarrant, Johnson and Parker counties in North Texas)
  • Presbyterian Healthcare Services (Central New Mexico)
  • Primecare Medical Network (Southern California (San Bernardino and Riverside Counties))
  • Renaissance Health Network (Southeastern Pennsylvania)
  • Seton Health Alliance (Central Texas (11 county area including Austin))
  • Sharp Healthcare System (San Diego County)
  • Steward Health Care System (Eastern Massachusetts)
  • Trinity Pioneer ACO, LC (Northwest Central Iowa)
  • University of Michigan (Southeastern Michigan)

Detailed descriptions of the Pioneer ACOs (PDF)

 

Initiative Details

The payment models being tested in the first two years of the Pioneer ACO Model are a shared savings payment policy with generally higher levels of shared savings and risk for Pioneer ACOs than levels currently proposed in the Medicare Shared Savings Program. In year three of the program, participating ACOs that have shown a specified level of savings over the first two years will be eligible to move a substantial portion of their payments to a population-based model. These models of payments will also be flexible to accommodate the specific organizational and market conditions in which Pioneer ACOs work.

The Pioneer ACO Model includes strong patient protections to ensure that patients have access to and receive high quality care. To accomplish this goal, Pioneer ACOs will be expected to improve the health and experience of care for individuals, improve the health of populations, and reduce the rate of growth in health care spending. Participating ACOs will be held financially accountable for the care provided to their aligned beneficiaries. In addition, CMS will publicly report the performance of Pioneer ACOs on quality metrics, including patient experience ratings, on its website.

 

Additional Information