ACO Update: Pioneer ACOs

Even before the comment period for draft ACO regulations closed on June 6, CMS began to offer alternative ACO structures. “Pioneer ACOs” are designed to fast-track organizations and partnerships that already have the infrastructure and experience to coordinate patients’ care across settings. Pioneer ACOs will be en route for a rapid transition from a shared savings and risk payment model to population-based payment that aligns with provider incentives from other payers. CMS has extended the deadline to submit a letter of intent for the Pioneer ACO program to June 30th, with applications now due August 19th.

In California, ACOs are receiving both support and skepticism:

• CAPG recently endorsed the Pioneer ACO model.
• Building on the successful CalPERS ACO pilot, Blue Shield is partnering with providers to create two new ACOs for the SF Health Services System.
• While Scripps Health and NAMM are creating an ACO-like integrated delivery system in San Diego, they may elect not to participate in the MSSP or Pioneer ACO program.
• Although Kaiser Permanente has a fully integrated delivery system, executives have stated that they do not plan to become an official ACO in the Medicare Shared Savings Program.