Pioneer financial results show why some ACOs are leaving the program

For the first time, CMS has published individual financial and performance results for the original 32 Pioneer accountable care organizations, which provide insight into why 12 of the ACOs exited the program.

The financial results for 2012, performance year one, were a mixed bag, with some ACOs posting significant savings and others recording losses. In 2012, New York City-based Montefiore ACO achieved 7.1 percent savings, the most of any Pioneer ACO. On the other end of the spectrum, Plus/North Texas ACO, based in Forth Worth and Arlington, recorded the most significant loss at 5.2 percent.

In July 2013, nine ACOs announced they would be leaving the Pioneer program, and the individual financial results provide insight into why those ACOs chose to leave the program. Eight of the nine organizations posted losses for the first performance year, and none of them earned shared savings.

Seven of the ACOs that exited the Pioneer program after performance year one decided to switch to the Medicare Shared Savings Program, which allows the organizations to share in savings but not be at risk for losses.

The financial results for 2013, performance year two, were much like the prior year, with some ACOs slowing health spending, and health spending accelerating for others. Montefiore ACO reported the most savings at 7 percent, and Bellin-ThedaCare Healthcare Partners reported a 5.6 percent loss, the most of any organization in 2013.

More ACOs exited the program after posting losses in performance year two. In August, San Diego-based Sharp Healthcare announced it was leaving the Pioneer program after determining its ACO was at risk for "significant shared loss" for performance year three. The individual financial results show Sharp Healthcare's ACO posted a loss of 0.3 percent in performance year one, and a loss of 1.3 percent in performance year two.

In September Flint, Mich.-based Genesys Physician Hospital Organization, Mishawaka, Ind.-based Franciscan Alliance, and Wayne, Pa.-based Renaissance Health Network also exited the Pioneer program, leaving only 19 of the original 32 ACOs in the program.

Below are the 19 original Pioneer ACOs that remain in the program.

1. Minneapolis-based Allina Hospitals and Clinics

2. Newton, Mass.-based Atrius Health

3. Phoenix-based Banner Health Network

4. Green Bay, Wis.-based Bellin-ThedaCare Healthcare Partners

5. Westwood, Mass.-based Beth Israel Deaconess Care Organization

6. New York City-based Montefiore ACO

7. San Francisco-based Brown & Toland Physicians  

8. Lebanon, N.H.-based Dartmouth-Hitchcock ACO

9. Brewer, Maine-based Beacon Health

10. Minneapolis-based Fairview Health Services

11. Northridge, Calif.-based Heritage California ACO

12. Detroit-based Michigan Pioneer ACO

13. Irvine, Calif.-based Monarch Healthcare

14. Mount Auburn Cambridge (Mass.) Independent Practice Association

15. Peoria, Ill.-based OSF Healthcare System

16. Minneapolis-based Park Nicollet Health Services

17. Boston-based Partners HealthCare

18. Boston-based Steward Promise

19. Fort Dodge, Iowa-based Trinity Pioneer ACO

More articles on ACOs:

ACO manifesto: 75 things to know about accountable care organizations
Growing from IPA to ACO: How physicians can remain independent in the shifting healthcare landscape
3 lessons learned from MSSP ACOs in performance year 1

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