Pioneer ACO Program Ripe for Improvement, Providers Say

Christopher Cheney, June 5, 2014

As Medicare officials mull new rules and a second round of participant recruitment for the Pioneer ACO program, healthcare providers are quick to point out how the gainsharing model can be improved.

It is far easier to get lost in an alphabet soup of acronyms than it is to find branding genius at a US federal agency.

But officials at the Centers for Medicare & Medicaid Services chose wisely when they picked "pioneer" as the key word for the moniker of their most ambitious gainsharing program. The Pioneer Accountable Care Organization model mirrors the pioneer experience of the 1800s wagon trains in the American West.

Just as the first wagon trains drew strong and ambitious settlers willing to accept the risks of traversing America's new frontier for the promise a brighter future, the CMS program was designed to draw healthcare providers willing to accept the gainsharing program's demands in exchange for potential financial reward.

"The Pioneer ACO Model is designed for healthcare organizations and providers that are already experienced in coordinating care for patients across care settings," the program's website states.

Launched in 2012 with 32 participants, Pioneer ACO is a relatively high-risk Medicare payment program because providers can gain or lose revenue based their ability to deliver value. "The Pioneer project is different because its ACOs are more advanced," says Ashley Thompson, vice president and deputy director of policy at the American Hospital Association.

Christopher Cheney

Christopher Cheney is the senior finance editor at HealthLeaders Media.


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