Editor’s Desk

Three More ACOs Drop Out of the CMS Pioneer Program

Peter Wehrwein

Three more organizations have exited CMS’s Pioneer accountable care organization (ACO) program, leaving just 19 of the original 32 participants in the fold for the elite program’s third year.

The Franciscan Alliance in Indianapolis, the Genesys Physician Hospital Organization in Flint, Mich., and the Renaissance Health Network in Wayne, Pa., in the southeastern part of the state, are leaving the Pioneer program, according to a list posted on the CMS website this afternoon.

Sharp Healthcare in San Diego had announced in August that it was dropping out.

Nine organizations left the Pioneer ACO program last year, leaving 23 participants in the program’s second year.  This round of dropouts brings the survivors down to 19.  Here is list of them: PioneerSurvivors

Sharp executives have said that Pioneer financial benchmarks worked against their ACO because they didn’t factor in higher wage costs in San Diego and special payments to hospitals for taking care of Medicaid payments.

The Pioneer program is an important proving ground for the much-talked-about ACO model because only large organizations with care coordination and cost control bona fides were invited to participate. The Pioneer organizations are eligible for greater payments if they beat financial benchmarks set by CMS than the ACOs participating in CMS’s Medicare Shared Savings Program, but they are also subject to greater penalties if they fall short.   

Peter Wehrwein is a veteran health care writer and editor who contributes frequently to Managed Care.