More Hospitals Ditch Pioneer ACO for Next Gen Model

Despite reaping millions in savings, even more Pioneer accountable care organization (ACO) model participants have chosen to exit the program by the Centers for Medicare and Medicaid Services (CMS).

Two Massachusetts hospital systems, Mount Auburn Cambridge Independent Practice and Steward Health Care Network, announced they are leaving the Pioneer ACO model.

Now, at least half of the 32 health systems that were originally taking part in the program have left, The Boston Globe reported.

Mount Auburn and Steward both said they will join the Next Generation accountable care organization program, a similar federal program that launches Jan. 1, 2016, because the rules make it more financially attractive to them than the Pioneer program.

The Next Generation ACO model offers greater benefits for partners, such as the ability to offer telehealth and enhanced home health visits post-hospitalization.

Mount Auburn Hospital’s physician network saved approximately $14 million during its three years in Pioneer program, but it anticipated to lose money under new rules that reduced the budget it would have received to care for patients, Barbara Spivak, president of the Mount Auburn Cambridge Independent Practice Association, the doctors group affiliated with Mount Auburn Hospital, told The Boston Globe.

Boston-based Steward, a for-profit doctor and hospital network, saved around $30 million over three years in the Pioneer pilot, but it also anticipates it can perform better under the Next Generation program. Steward is the second largest health care system in New England, with 10 hospital campuses, 6 ambulatory surgery centers, home care, hospice and other community-based services.

The news of the departures in Massachusetts comes roughly two weeks after a New Hampshire-based nonprofit academic health system, Dartmouth-Hitchcock Medical Center, announced it had left the Pioneer ACO program.

The Pioneer ACO model generated over $384 million in savings to Medicare during its first two years.

Written by Mary Kate Nelson