Most Pioneer, Next Generation ACOs generated shared savings in 2016, CMS data show

Editor's note: This story was updated on Oct. 18, 2017.

A majority of the accountable care organizations (ACOs) participating in CMS' Pioneer ACO and Next Generation ACO models during the 2016 performance year experienced shared savings, according to CMS data released Friday.

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Pioneer ACO performance

The data show six of the eight ACOs that participated in the Pioneer program for the 2016 performance each completed the year with at least $1 million in shared savings.

Under the Pioneer program, which launched in January 2012 with 32 participants and ended in December 2016 with eight, participating providers contracted with CMS to meet quality targets and assume new risk when caring for a set population of Medicare beneficiaries. In exchange, participants receive additional financial incentives. The program was designed to reward early adopters of coordinated care models and offer the health industry an example of successful outcomes-based pay models.

The six ACOs that generated shared savings in the program's final year were:

  • Banner Health Network, which generated $10,940,821 in shared savings; 
  • MichiganPioneer ACO, which generated $7,481,636 in shared savings; 
  • Montefiore ACO, which generated $7,413,869 in shared savings;
  • Atrius Health, which generated $6,847,951 in shared savings; 
  • Allina Health, which generated $3,425,746 in shared savings; and  
  • FairviewHealth Services, which generated $1,018,894 in shared savings.  

Two ACOs—Monarch HealthCare and Partners HealthCare—did not generate shared savings under the Pioneer program, according to CMS data.

In terms of overall quality scores, the CMS data showed:

  • Atrius Health scored a 95.74 percent;
  • Montefiore ACO scored a 95.16 percent;
  • Partners HealthCare scored a 94.51 percent;
  • Fairview Health Services scored a 94.30 percent;
  • Allina Health scored a 92.94 percent;
  • Banner Health Network scored a 91.86 percent;
  • Monarch HealthCare scored a 90.25 percent; and
  • Michigan Pioneer ACO scored an 88.93 percent.

Next Generation ACO performance

CMS also released data that show 11 of the 18 Next Generation ACOs that participated in 2016—the model's first performance year—generated shared savings, Becker's Hospital Review reports.

The Next Generation model, unveiled in March 2015, uses a combination of fee-for-service and capitation and requires providers to take on more risk than other ACO models. It creates four payment systems and two risk tracks for its participants, including one with almost full risk. Next Generation ACOs also qualify as advanced alternative payment models under MACRA for the 2017 reporting year, meaning those participating this year could see additional incentive payments in 2019, Becker's Hospital Review reports.

The 11 ACOs that generated shared savings in the program's first year were:

  • Baroma Health Partners, which generated $12,254,176 in shared savings;
  • Triad HealthCare Network, which generated $10,735,910 in shared savings;
  • Iowa Health Accountable Care, which generated $10,527,767 in shared savings;
  • Trinity Health ACO, which generated $6,529,274 in shared savings;
  • Deaconess Care Integration, which generated $5,719,530 in shared savings;
  • Pioneer Valley Accountable Care, which generated $4,683,960 in shared savings;
  • Henry Ford Physician ACO, which generated $3,938,137 in shared savings;
  • Bellin Health Partners, which generated $1,400,147 in shared savings;
  • ThedaCare ACO, which generated $1,348,292 in shared savings;
  • Prospect ACO, which generated $938,839 in shared savings; and
  • Steward Integrated Care Network, which generated $272,139 in shared savings.

According to CMS, seven Next Generation ACOs reported losses ranging from $63,570 to $6,151,383  (Haefner, Becker's Hospital Review, 10/13; Haefner, Becker's Hospital Review, 10/16).

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