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What You Need to Know about the Pioneer ACO Announcement

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This past Monday, CMS announced the findings of a recent analysis which found that $384 million was saved over the first two years in the Pioneer ACO program. Most of the savings was accrued in the first performance year, totaling $279.7 million.

Performance of the ACOs was mixed. Specifically:

    Ten of the 32 Pioneer ACOs that started the program in 2012 had significant savings in both years.
    Another ten of the ACOs experienced statistically significant savings in only one of the two performance years; two of these ACOs experienced had notable loses in the other performance year.
    Twelve of the ACOs had no statistically distinguishable savings or losses.
    Nine Pioneer ACOs exited the program by the end of 2013; their results are included in this report.

These recently published results were generated using a methodology that compares Pioneer ACO-aligned Medicare beneficiaries with non-aligned Medicare beneficiaries in the same geographic market area. This methodology differs from the national benchmark methodology used by CMS to generate shared savings and losses for payment purposes.

Avalere worked on this analysis through an Evaluation Contract led by L&M Policy Research. Avalere Health, Abt Associates, Social & Scientific Systems, and Truven Health Analytics participated in both the qualitative and quantitative analyses included in this report.

Read the full report.

Access CMS’ press release.

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