Pioneer ACOs Year One: On the Path to a Learning Health Care System, on the Health Affairs Blog

Doug Hastings, Chair of the firm's Board of Directors and a Member of the Firm in the Health Care and Life Sciences practice, in the Washington, DC, office, wrote an article titled "Pioneer ACOs Year One: On the Path to a Learning Health Care System."

Following is an excerpt:

The Centers for Medicare and Medicaid Services yesterday announced results from the first performance year of the Pioneer Accountable Care Organization Model. The Pioneer Model should be seen as part of a crucial phase of testing alternative payment and delivery models in an effort to achieve greater value in health care. One year's results should not be seen as a definitive outcome or leading to a dispositive conclusion, but rather as a valuable source for learning.

The Pioneers represent 32 of over 425 public and private market ACOs reportedly in operation nationally. The two-sided risk model they assume is more advanced than the shared-savings-only approach of the Medicare Shared Savings Program Track 1 and most commercial ACO arrangements, but less advanced from a full risk perspective than many capitated provider arrangements in place around the country. All of these efforts bring greater definitional clarity to accountable care and accountable care organizations. ...

ACO skeptics clearly remain. Among the doubts and cautions that have been raised are that ACOs will drive insufficient change in physician behavior and patient engagement, result in insufficient savings, create a specialist (and thus patient) backlash, suffer from lack of agreement over measures and metrics, and drive up prices due to consolidation. These are legitimate concerns. But such concerns should not mean that the testing should slow down. Rather, in my view, it should accelerate, given some early positive results and the ongoing cost and quality challenges faced by our health care system.