Accountable care organizations in Medicare's Pioneer ACO program failed to win a one-year reprieve from having financial incentives tied to their performance on quality benchmarks.
The CMS made an effort to address the concerns of the 32 organizations chosen for the program, launched in January 2012 as an early and high-profile effort to test and nurture the model. It's unclear whether the agency went far enough to maintain the commitment of the Pioneers, who suggested in a February letter to the CMS Innovation Center that they needed clarity in order to “make informed decisions regarding our ongoing participation.”
In a letter to Pioneers last week, the CMS rejected the ACOs' call to award financial incentives this year based on whether organizations reported quality scores and postpone payment tied to performance benchmarks until 2014. The agency said it would replace “flat percentage” benchmarks with empirically based benchmarks.
The new ones will be based on recently received data and will be proposed soon, according to the CMS letter—the flat-percentage benchmarks were proposed because that data was not available, the letter said. The benchmarks will be applied to Pioneers this year and to another 220 ACOs in the Medicare Shared Savings Program in 2014.