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Pioneer ACOs continue steady and modest improvements

The Centers for Medicare and Medicaid Services tracks the yearly progress of Pioneer ACOs, and had good news to report from 2014.

The Centers for Medicare and Medicaid Services (CMS) can make a strong claim that the accountable care organization (ACO) payment model works. With Pioneer ACOs earning a total of $120 million in savings, 2014 proved to be a good financial year for ACOs. CMS has more than financial data to prove the ACO model is benefitting the healthcare industry. The mean quality of care score at Pioneer ACOs rose to 87.2% in 2014, a 2% increase from 2013.

During 2014, the 20 Pioneer ACOs saw 622,265 beneficiaries or 2% more than the 607,945 beneficiaries accounted for in 2013. Of the ACOs taking part in the Medicare Shared Savings Program, 92 held their total spending a combined $806 million under their targets in 2014. Those same 92 ACOs earned $341 million in shared savings last year. Both of those numbers increased from 2013, a year in which 58 ACOs spent $705 million less than they projected and split $315 in shared savings payments.

"These results show that accountable care organizations are on the path towards transforming how care is provided. Many of these ACOs … can deliver a higher level of coordinated care that leads to healthier people and smarter spending," Andy Slavitt, acting administrator for CMS, said in a news release.

Again, the financial gains were not the only significant news. Shared Savings Program ACOs reported improvements in 27 of 33 quality measures, including patient-physician communication, screening for tobacco use and cessation, as well as the deployment of EHR systems. The mean quality score of Pioneer ACOs increased by 15.4% from 2012, the program's first performance year.

Another plus of being part of an ACO is not facing the reimbursement cuts scheduled for 2016. Those cuts will be given to those that have not participated in the Physician Quality Reporting System (PQRS). Since part of the ACO reporting requirements fulfills the needs of the PQRS, ACO participants will be immune.

Many of the Pioneer ACOs have stated that being early adopters of the ACO model helped them grow in the program, and identify what does and doesn't work in each of their situations. These lessons will also help pave the way for new ACO applicants and allow them to make a smoother transition into the ACO payment model, while maintaining high quality of care.

About the author:
Reda Chouffani is vice president of development at Biz Technology Solutions Inc., which provides software design, development and deployment services for the healthcare industry. Let us know what you think about the story; email [email protected] or contact @SearchHealthIT on Twitter.

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