Pioneer ACOs Report Positive Results: Is This a Reason for Optimism?

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ACO-thumb2Let’s end the week on an optimistic note.

As we covered a month ago on this site, nine of the 32 Pioneer Accountable Care Organizations (ACOs) are bailing on the program. At the time this was reported, there was glee among opponents of healthcare reform. After all, this was proof that the Affordable Care Act—so-called Obamacare—was a failure. It was bombing royally. It was, to use Sen. Marco Rubio’s connotation, the New Coke of government policies.

Not so fast, Debra Ness and William Kramer say at the Health Affairs Blog.

How often is it, they write, “that progress comes in straight lines”? When tackling all complex problems, isn’t it largely trial-and-error when starting out, a period of testing and innovating and…trying?

Most of us implement trial-and-error with our new iPhone or tech gadget or laptop. Imagine trying to reform the entire American healthcare system into something that is more accessible and more affordable for the nation’s citizens. That’s going to take some trial-and-error, too, especially after decades of one system ruling supreme.

“Getting mixed results from the first year of testing Pioneer Accountable Care Organizations was to be expected,” they write. “In fact, for those of us with experience working with our healthcare system and a dose of realism in our perspectives, it was all but inevitable.”

Let’s focus, instead, they continue, on what was a success from the first year.

“All 32 of the Pioneer ACOs met the quality performance metrics. The 32 Pioneer ACOs performed well on cancer screenings, blood pressure control, cholesterol control for diabetes patients, and other indicators of quality care. Twenty-five of the 32 had success in reducing hospital readmission rates.

“More than a third also succeeded, during just this first year, in reducing costs, producing cumulative savings of more than $87 million and saving Medicare nearly $33 million. For the 669,000 Medicare patients in the program, costs increased by just 0.3 percent over the course of the year – a much smaller increase than the 0.8 percent experienced by similar Medicare beneficiaries over the same period. Just two Pioneer ACOs lost money, and their losses totaled $4 million.”

As for those nine Pioneer ACOs that left the system, wasn’t that inevitable, too? Is it not expected “that some healthcare systems would re-evaluate their participation and choose to move on”?

Is it not true that 23 Pioneer ACOs are actually continuing with the program? Isn’t that more impressive than seeing nine leave? With the majority staying behind and with the impressive results listed above, it’s hard to declare healthcare reform a failure just yet.

In fact, so far, it seems anything but a failure.

There are a few notes to be taken, however, from the first year of the ACO, they write. We’ll look at those notes on Monday.

In the meantime, are you encouraged by the results the Pioneer ACOs experienced after one year of trying out the program? How does this impact your view of healthcare reform and ACOs? Are growing pains to be expected? How do you plan to deal with those pains in your organization?

-by Pete Fernbaugh

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