Pioneer ACO

The math of ACOs | 8/20/2020

… organization (ACO) , in which physicians and/or hospitals assume responsibility for the total cost of care for a population of patients. Launched by the Centers for Medicare & Medicaid Services (CMS) Innovation Center in 2012, Pioneer ACO was the first such model design to generate savings for Medicare. In this incarnation, Medicare set a benchmark for total cost of care per attributed ACO beneficiary: If total cost of care was kept …

Accountable Care Organization: What are the Beneficiary Protections under the Pioneer ACO Model? | 1/15/2020

Simply put, an ACO is a group of providers that is responsible for the costs of caring for a population while hitting some basic quality metrics, it keeps the difference. In summary, cms has also announced a pioneer aco model which will test alternative savings and alignment. Next Services Next generation builds upon experience from earlier aco models, pioneer and shared savings, protections are available to ACOs that are in …

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ACO Implementation: Current evidence and a way forward | 1/2/2020

… move from volume to value. What are ACOs? ACOs are groups of providers that are collectively accountable for the cost and quality of care for a defined patient population. Examples include the federal Medicare Pioneer ACO program, state-level Medicaid ACO programs, and commercial ACOs. The design of these care models differs. A key feature is the shift of financial risk to providers, where providers can “share savings” that result …

Accountable Care Organization: How are beneficiaries selected for the Pioneer ACO Model? | 12/26/2019

… to assume some portion of the risk for cost and quality for a panel of beneficiaries through a variety of value-based payment models over a specified period of time, first, cms announced the pioneer aco model, an accelerated path to aco formation for those ready to assume utilization. Equally important, financing and inadequate capital for information technology have been cited by rural providers as significant infrastructure obstacles to ACO …

Accountable Care Organization: What is the Pioneer ACO Model initiative? | 12/26/2019

… increased program flexibility and allows participants to earn a larger share of obtained savings. As well as be responsible (at risk) for a greater share of any resulting losses, savings program (mssp) and the pioneer aco model. As well as its new next generation model. As a matter of fact, akin models, which strongly influence provider delivery arrangements and program costs, differ significantly along many dimensions important to beneficiaries and …

New Rules for ‘Direct Contracting’ ACO Model | Managed Care Magazine | 12/4/2019

… CMS is trying to do with the Direct Contracting Model, according to Fiske, is remove some of the administrative burden for providers. ACOs got started as part of the ACA. The first program, the Pioneer ACO Model, was launched in March 2011. Since then the CMS Innovation Center, created by the ACA to develop and test federal government healthcare programs, has tried out various kinds of ACOs. The National Association …

PARTNERS HEALTHCARE TRANSITIONING INTO MEDICARE SHARED SAVINGS PROGRAM | Financial Buzz | 8/22/2019

… patient care. Partners was one of the first Medicare Pioneer ACOs in the country, generating $36.7 million in cost savings for the federally funded program between 2012 and 2016. When CMS phased out the Pioneer ACO Model, Partners converted to the Next Generation ACO. “This evolution of our Medicare ACO represents our ongoing commitment to value-based care, clinical care transformation and care management programs, including high-risk care management …

Industry Voices—A look at how providers could fare in CMS’ new primary care payment models | FierceHealthcare | 7/16/2019

… analogous model to Medicare Advantage without the health plan intermediary, the PBP model provides large sophisticated groups with the ability to directly contract with CMS. However, this is not without complexity and risk. The Pioneer ACO model showed us the challenges associated with government data lags. Even though the Medicare Advantage plans have delegated some of the risk functions, historically, the health plans have maintained the majority of the necessary …

Healthcare organizations ask CMS to expand Next Generation ACOs | FierceHealthcare | 6/1/2019

… ACO program is ready for this step.” RELATED: CMS finalizes ACO overhaul, shortening pathway for financial risk The letter notes that the Centers for Medicare & Medicaid Services has already taken these steps for the Pioneer ACO program. In addition, it recently made significant changes to the Medicare Shared Savings Program, transforming it into Pathways to Success with the goal of pushing more providers into taking on financial risk. Expanding Next …

Provider Groups Want to Make Next Generation ACOs Permanent | RevCycle Intelligence | 5/14/2019

… nearly 2 million Medicare beneficiates. However, the program that launched in 2016 is only a five-year demonstration unless the HHS Secretary chooses to make the program a permanent fixture like he did the Pioneer ACO model, the provider groups explain. READ MORE: Understanding the Fundamentals of Accountable Care Organizations CMS launched the Pioneer ACO model in 2012 with 32 ACOs. At the end of the third performance period in …

Medicare ACOs in Premier Population Health Collaborative Outperform Peers by 57% in Achieving Shared Savings | Business Wire | 12/21/2017

… ACOs outperformed their peers in 18 out of the 33 quality measures, with the greatest gains in meeting meaningful use requirements, fall prevention and pneumonia vaccinations. 100 percent of PHMC Next Generation (NGACOs) and Pioneer ACO s achieved shared savings compared to half for all other NGACOs and Pioneers. PHMC NGACOs and Pioneers represent 15 percent of the total program participants but achieved 29 percent of the total program savings. “Achieving …

Lisa Stevens Anderson Joins Equality Health As Chief Operating Officer To Manage Growing Portfolio | PRWeb | 11/7/2017

… Vice President and Chief Executive Officer of Banner Health Network (BHN), she helped build Arizona’s largest Accountable Care Organization with more than 5,000 providers and 480,000 members. In 2015, the fourth year of BHN’s Pioneer ACO Program, Banner delivered the top financial performance in the country, in addition to achieving 95th percentile in quality. Her previous experience also includes serving as the Vice President of Provider Services for TriWest HealthCare …

Montefiore Shines As A Top Performing Pioneer ACO | PR Newswire | 10/18/2017

Montefiore Shines As A Top Performing Pioneer ACO Health System Demonstrates Optimal Patient Care Doesn’t Require a Hefty Price Tag News provided by Oct 18, 2017, 11:33 ET Share this article NEW YORK , Oct. 18, 2017 /PRNewswire-USNewswire/ – Montefiore delivered excellent patient care and generated more than $73 million in savings to Medicare as a Pioneer Accountable Care Organization (ACO), according to new data from the Centers for Medicare and …

Coordinated Care

Franciscan ACO High-Quality Performance Results in $14.4 Million Savings | Globe Newswire | 11/7/2019

… As a participant in an ACO, Franciscan partners with physicians, hospitals and other advance practice providers to provide high quality, coordinated care to Medicare patients. Franciscan ACO earned a quality index score of 94.48 out … Affordable Care Act. With the launch of the Franciscan Alliance Pioneer ACO in 2012, the hospital system began pursuing a more quality centered system of care when Franciscan ACO transitioned from the Pioneer program into …

Franciscan ACO High-Quality Performance Results in $14.4 Million Savings | Markets Insider | Business Insider | 11/7/2019

… As a participant in an ACO, Franciscan partners with physicians, hospitals and other advance practice providers to provide high quality, coordinated care to Medicare patients. Franciscan ACO earned a quality index score of 94.48 out … Affordable Care Act. With the launch of the Franciscan Alliance Pioneer ACO in 2012, the hospital system began pursuing a more quality centered system of care when Franciscan ACO transitioned from the Pioneer program into …

Medicare Advantage

Franciscan ACO High-Quality Performance Results in $14.4 Million Savings | Globe Newswire | 11/7/2019

… Medicare Advantage, Humana Medicare Advantage, and United Healthcare Medicare Advantage. Franciscan Health was among the first and few to enter the realm of ACO programs which was one of the manifestations of the 2010 Affordable Care Act. With the launch of the Franciscan Alliance Pioneer ACO in 2012, the hospital system began pursuing a more quality centered system of care when Franciscan ACO transitioned from the Pioneer program into the …

Franciscan ACO High-Quality Performance Results in $14.4 Million Savings | Markets Insider | Business Insider | 11/7/2019

… Medicare Advantage, Humana Medicare Advantage, and United Healthcare Medicare Advantage. Franciscan Health was among the first and few to enter the realm of ACO programs which was one of the manifestations of the 2010 Affordable Care Act. With the launch of the Franciscan Alliance Pioneer ACO in 2012, the hospital system began pursuing a more quality centered system of care when Franciscan ACO transitioned from the Pioneer program into the …

Shared Savings Program

PARTNERS HEALTHCARE TRANSITIONING INTO MEDICARE SHARED SAVINGS PROGRAM | Financial Buzz | 8/22/2019

Boston, Partners HealthCare is now participating in the Medicare Shared Savings Program (MSSP) through the Centers for Medicare and Medicaid Services (CMS). The MSSP Accountable Care Organization (ACO) allows Partners to extend care to roughly … to patient care. Partners was one of the first Medicare Pioneer ACOs in the country, generating $36.7 million in cost savings for the federally funded program between 2012 and 2016. When CMS phased out the …

Healthcare organizations ask CMS to expand Next Generation ACOs | FierceHealthcare | 6/1/2019

Pioneer ACO program. In addition, it recently made significant changes to the Medicare Shared Savings Program, transforming it into Pathways to Success with the goal of pushing more providers into taking on financial risk. Expanding Next Gen would adhere to that goal while offering an alternative option for organizations looking to enter an advanced payment arrangement, the groups wrote. “Creating a permanent NGACO offering, while simultaneously building on its success …

Medicaid

PARTNERS HEALTHCARE TRANSITIONING INTO MEDICARE SHARED SAVINGS PROGRAM | Financial Buzz | 8/22/2019

Medicaid Services (CMS). The MSSP Accountable Care Organization (ACO) allows Partners to extend care to roughly 10,000 additional patients, serving a total of approximately 125,000 Medicare patients; and adds nearly 2,000 additional Partners providers, totaling 9,300 providers supporting the Medicare population. Partners has transitioned to MSSP from its previous Medicare ACO, the Next Generation Accountable Care model, without disruption to patient care. Partners was one of the first Medicare Pioneer …

Industry Voices—A look at how providers could fare in CMS’ new primary care payment models | FierceHealthcare | 7/16/2019

The Center for Medicare & Medicaid Innovation strikes again with an innovative program designed to reduce Medicare program expenditures while improving the quality of care. The Centers for Medicare & Medicaid Services innovation center announced its latest … CMS. However, this is not without complexity and risk. The Pioneer ACO model showed us the challenges associated with government data lags. Even though the Medicare Advantage plans have delegated some of the risk functions …

Medicare

PARTNERS HEALTHCARE TRANSITIONING INTO MEDICARE SHARED SAVINGS PROGRAM | Financial Buzz | 8/22/2019

Boston, Partners HealthCare is now participating in the Medicare Shared Savings Program (MSSP) through the Centers for Medicare and Medicaid Services (CMS). The MSSP Accountable Care Organization (ACO) allows Partners to extend care to roughly … to patient care. Partners was one of the first Medicare Pioneer ACOs in the country, generating $36.7 million in cost savings for the federally funded program between 2012 and 2016. When CMS phased out the …

Industry Voices—A look at how providers could fare in CMS’ new primary care payment models | FierceHealthcare | 7/16/2019

The Center for Medicare & Medicaid Innovation strikes again with an innovative program designed to reduce Medicare program expenditures while improving the quality of care. The Centers for Medicare & Medicaid Services innovation center announced its latest … CMS. However, this is not without complexity and risk. The Pioneer ACO model showed us the challenges associated with government data lags. Even though the Medicare Advantage plans have delegated some of the risk functions …

Population Health

Industry Voices—A look at how providers could fare in CMS’ new primary care payment models | FierceHealthcare | 7/16/2019

… large sophisticated groups with the ability to directly contract with CMS. However, this is not without complexity and risk. The Pioneer ACO model showed us the challenges associated with government data lags. Even though the … providers’ reliance on the health plan to participate in managing population health. It may also serve as a catalyst to encourage providers to participate in Direct Contracting as a way of moving more traditional fee …

Industry Voices—A look at how providers could fare in CMS’ new primary care payment models | FierceHealthcare | 7/15/2019

… large sophisticated groups with the ability to directly contract with CMS. However, this is not without complexity and risk. The Pioneer ACO model showed us the challenges associated with government data lags. Even though the … providers’ reliance on the health plan to participate in managing population health. It may also serve as a catalyst to encourage providers to participate in Direct Contracting as a way of moving more traditional fee …

Health Management

Industry Voices—A look at how providers could fare in CMS’ new primary care payment models | FierceHealthcare | 7/16/2019

… large sophisticated groups with the ability to directly contract with CMS. However, this is not without complexity and risk. The Pioneer ACO model showed us the challenges associated with government data lags. Even though the … Advantage plans that have the benefit of member assignment and health management organization networks still start with medical loss ratios above 85%. Therefore, these types of models will be best suited for highly sophisticated groups …

Industry Voices—A look at how providers could fare in CMS’ new primary care payment models | FierceHealthcare | 7/15/2019

… large sophisticated groups with the ability to directly contract with CMS. However, this is not without complexity and risk. The Pioneer ACO model showed us the challenges associated with government data lags. Even though the … Advantage plans that have the benefit of member assignment and health management organization networks still start with medical loss ratios above 85%. Therefore, these types of models will be best suited for highly sophisticated groups …

ACOs

Healthcare organizations ask CMS to expand Next Generation ACOs | FierceHealthcare | 6/1/2019

… to the letter include the Health Care Transformation Task Force (HCTTF), the Medical Group Management Association, the National Association of ACOs and Premier. Webinar Bridging the Gap: How Regional Communication Networks Bring Value to Your … Medicare & Medicaid Services has already taken these steps for the Pioneer ACO program. In addition, it recently made significant changes to the Medicare Shared Savings Program, transforming it into Pathways to Success with the goal …

Healthcare organizations ask CMS to expand Next Generation ACOs | FierceHealthcare | 5/31/2019

… to the letter include the Health Care Transformation Task Force (HCTTF), the Medical Group Management Association, the National Association of ACOs and Premier. “Current Next Gen ACOs have proven that this model saves money and … Medicare & Medicaid Services has already taken these steps for the Pioneer ACO program. In addition, it recently made significant changes to the Medicare Shared Savings Program, transforming it into Pathways to Success with the goal …