Pioneer ACO Model Generates Substantial Savings to Medicare

| Posted On May 18, 2015 | By:

We are delighted to offer our congratulations to the Centers for Medicare & Medicaid Services (CMS) and the Center for Medicare and Medicaid Innovation (CMS Innovation Center) on their recent announcement regarding the independent evaluation showing the Pioneer Accountable Care Organization (ACO) model generated a savings of $384 million to Medicare over its first two years. This report demonstrates that accountable care can reduce the growth in costs while also improving quality.

Health and Human Services (HHS) Secretary Sylvia M. Burwell said in the press release: “The Pioneer ACO Model has demonstrated that patients can get high quality and coordinated care at the right time, and we can generate savings for Medicare and the health care system at large.”

Based on this evaluation, we are very proud to say that Atrius Health showed meaningful savings in both years of the Pioneer ACO model, and had the highest per beneficiary per year savings among Boston Pioneer ACOs in the second year. Our accumulated savings amounted to approximately $1,355 per year per beneficiary over the first two years ($552 per beneficiary in year one and $803 per beneficiary in year two.) Most importantly, Atrius Health has demonstrated in this evaluation that we can significantly reduce the cost of care as compared with local trends while scoring the highest on quality measures among New England ACOs. Atrius Health achieved well above the 90th percentile on the important Diabetes Composite. We are particularly proud that we minimized the risk of serious complications such as heart attack, stroke, blindness, neuropathy, and kidney failure among our diabetic patients. Another area where we scored very well was our performance on controlling blood pressure among seniors with known hypertension. Our score was better than 90% of the organizations against which we were compared.

Emily Brower, Executive Director of Accountable Care Program at Atrius Health, stated “We are thrilled with these results as we have worked hard to focus on our most high risk patients by proactively anticipating and meeting their needs.”

The methodology for these evaluations is different from the methodology used for awarding savings in the first two years of the Pioneer ACO Model. This independent evaluation compares the Pioneers against a control group in their own markets and is different from how financial performance is measured in the Pioneer benchmark itself, which uses national cost and trend. We are pleased to see that the Innovation Center is incorporating more of a local market trend into the second phase of the program (2015 and 2016 which are years 4 and 5) and the Next Generation Model ACO.

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