CMS reports Pioneer ACO cost savings, improved care

Medicare costs for more than 669,000 beneficiaries within the Pioneer Accountable Care Organizations (ACOs) last year grew at a slower pace, 0.3%, compared to the 0.8% growth rate in spending for those beneficiaries not part of this new model, according to a press statement.

The Centers for Medicare & Medicaid Services (CMS) noted both higher quality care and lower Medicare expenses associated with the Pioneer ACO Model, which was launched by the CMS Innovation Center and is part of the Affordable Care Act’s attempt to realign payment incentives.

“These results show that successful Pioneer ACOs have reduced costs for Medicare and improved the quality of care for their patients,” said CMS Administrator Marilyn Tavenner. “The Afforable Care Act has given us a wide range of tools to realign payment incentives in Medicare and Medicaid, and these efforts are paying off.”

Thirteen of the 32 pioneer ACOs generated a gross savings of $87.6 million last year and saved the Medicare Trust Fund almost $33 million. Two pioneer ACOs had shared losses that totaled $4 million.

The main drivers of ACO savings were reductions in hospital admissions and readmissions. Twenty-five of the 32 pioneer ACOs had lower risk-adjusted readmission rates for beneficiaries than the benchmark rate for all Medicare fee-for-service beneficiaries, the statement said.

Blood pressure control among pioneer ACO beneficiaries with diabetes was better (68%) than the blood pressure control among beneficiaries with diabetes in 10 management care plans (55%) across 7 states from 2000 to 2001. The median low-density lipoprotein cholesterol rates were better at 57% among pioneer ACO beneficiaries compared to a median rate of 48% for the managed care beneficiaries, according to the statement.

Seven pioneer ACOs are leaving the pioneer ACO program to apply for the Medicare Shared Savings Program and two pioneer ACOs are leaving the pioneer ACO program and do not intend to join the other ACO model.For more information about the Pioneer ACO Model, visit http://innovation.cms.gov/initiatives/Pioneer-ACO-Model/.

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