Seven of the nine participants in CMS's pilot program for accountable care organizations are applying to transition to the Medicare Shared Savings Program, while two are abandoning the program completely.
Nine of the 32 Pioneer ACOs will not participate in third year of the Center for Medicare & Medicaid Services' pilot program for accountable care organizations, HealthLeaders Media has learned.
Seven of the nine are applying to transition to the Medicare Shared Savings Program, while two are abandoning the program completely, although CMS declined to identify which ACOs are leaving and which are simply shifting to the MSSP.
The nine departing ACOs are:
- Prime Care Medical Network Inc., an IPA-based ACO serving San Bernadino and Riverside counties in California
- University of Michigan Health System in Ann Arbor
- Physician Health Partners LLC, a medical management company in Denver
- Seton Health Alliance, a network of providers comprised in the 11-county Austin area
- "Plus ACO," a partership between North Texas Specialty Physicians and Texas Health Resources
- Healthcare Partners Nevada ACO LLC, a multispecialty medical group and IPA serving Clark and Nye counties in Nevada
- Healthcare Partners California ACO LLC, a multispecialty medical group and IPA serving Los Angeles and Orange counties in California
- JSA Care Partners LLC, a primary medical group and IPA serving the Orlando, Tampa and South Florida area.
- Presbyterian Healthcare Services, an integrated delivery system serving the Albuquerque area
The ACOs had until close of business on July 15th to notify CMS of any status change in their Pioneer ACO participation.
The Pioneer program was developed as an alternative to the MSSP after organizations experienced with coordinating patient care and managing risk complained that the MSSP program was too stringent in its design.
See Also: Plus ACO Could Remain a Pioneer ACO
The nine are departing the Pioneer ACO program prior to the third year of participation, however, which is when participants would be expected to transition away from fee-for-service payment to population-based payment and full risk arrangements.
In a press statement released Tuesday morning heralding the first-year results, CMS noted that two of the ACOs “shared losses totaling approximately $4.0 million.”
According to CMS, however, 13 of the 32 Pioneer ACOs produced shared savings with CMS, generating a gross savings of $87.6 million in 2012. The Pioneers are also credited with saving nearly $33 million to the Medicare Trust Funds.