First year of Pioneer Program shows reduction in Medicare spending

The Pioneer accountable care organization program produced moderate Medicare savings, according to a study published Wednesday in The New England Journal of Medicine. ACOs with higher baseline spending and those serving high-spending areas shared in greater savings than organizations with a lower baseline and those serving low-spending areas, according to the report.

Three years ago, 32 organizations joined the Pioneer Program, which allowed participants to share in Medicare savings if the organizations generated a sufficient reduction in spending for an attributed group of patients and met quality benchmarks. Pioneer ACOs share in savings, and also share in risk, so if spending exceeded benchmarks, the organizations incurred losses.

In the study, researchers aimed to clarify if initial reports of Pioneer ACO savings were systematic, or due to other factors within individual organizations or markets. Researchers compared Medicare claims for beneficiaries in Pioneer ACOs with claims for other beneficiaries in two time periods —2009 to 2011 and 2012 — to determine the differential change in spending. Spending was adjusted based on market characteristics and individual patient and clinical characteristics.

Researchers also compared ACOs based on the financial integration of hospitals and physician groups, baseline spending and if the programs withdrew from the program or not.


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