Pioneer ACOs Want CMS to Delay Pay-for-Performance Obligations

Many health systems behind CMS' 32 Pioneer Accountable Care Organizations disagree with the Patient Protection and Affordable Care Act's approach to quality measurement and are demanding changes to the Pioneer program, according to a Washington Post report.

When CMS first unrolled its ACO program, the agency proposed more than 70 quality metrics that would determine whether hospitals could receive bonus payments. In response to criticism from providers, CMS trimmed that list to 33 metrics in its final rule.

For the past year, Pioneer ACOs have received payments for reporting data on the 33 metrics. No payments were linked to the ACOs' outcomes in 2012. But this has since changed. Now, in 2013, providers are scheduled to transition from pay-for-reporting to pay-for-performance. This has left many pioneer ACOs and their respective health systems anxious, according to the report.

Late last month, several Pioneer ACOs sent a letter to the CMS branch overseeing the Pioneer ACOs, asking it to reconsider the quality benchmarks. The letter also requests that 2013 be another year in which ACOs are required to only report data rather than having reimbursement tied to their performance.

The Pioneer organizations gave CMS an April 2 deadline to accept or deny its recommendations so the ACOs can "make informed decisions regarding our ongoing participation," according to the letter. Dartmouth-Hitchcock Healthcare ACO in Lebanon, N.H., University of Michigan in Ann Arbor, and Partners Medical Group, Beth Israel Deaconess Care and Steward Health Care System in Boston were just some of the organizations that signed the letter.

A copy of the Pioneer ACOs' letter to CMS can be found here via The Washington Post.

Editor's note: An earlier version of this story was published with the headline: "19 Pioneer ACOs Want CMS to Delay Pay-for-Performance Obligations." That headline referenced information in the Washington Post article about the number of ACOs that signed the letter to CMS last month. Since the time of publication, more organizations have signed the letter, as evidenced by the linked letter pdf above.

More Articles on ACOs:

Specialty ACOs: The Next Step in Accountable Care
Employee ACOs: Building a Base for Accountable Care
ACOs Have 3 Fatal Flaws, Experts Say


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