The revelation that nine of the 32 accountable care organizations in Medicare's Pioneer program might leave it -- four of them to join the regular Medicare shared savings program (MSSP) -- has raised some eyebrows in the healthcare industry.

The reason is that the Pioneer ACOs, which are among the most advanced healthcare organizations, are expected to take downside risk -- meaning they can lose money -- sooner than the ACOs in the MSSP, which have only upside risk -- meaning they share savings but not losses -- for the first three years. So the departure of nearly a third of the Pioneers would raise some questions about the viability of the government's plan to get providers to take financial responsibility for care.

Tom Cassels, leader of the healthcare advisory board of The Advisory Board Co., told Information Week Healthcare that the exit of the nine Pioneer ACOs, which has been confirmed by the Centers for Medicare and Medicaid Services (CMS), is not terribly significant. For one thing, he noted, the Pioneer ACOs also have risk contracts with commercial payers, self-insured employers and Medicaid plans. So their departure from the Pioneer program doesn't mean that they're shifting back to a fee-for-service system, he said. Read full story on InformationWeek


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