As the deadline nears for Medicare's first accountable care organizations to decide whether they will continue with the initiative, at least one is debating whether to leave.
Albuquerque, N.M.-based Presbyterian Healthcare Services must choose in the next few weeks whether to continue for at least another two years in Medicare's Pioneer accountable care program, which was launched in January 2012 under the Center for Medicare and Medicaid Innovation.
Jim Hinton, president and CEO of Presbyterian Healthcare Services, said the health system is in talks with federal officials about possible changes to the program's design that would address how geographic variation in healthcare costs and use could affect potential bonus payouts.
The Innovation Center has contracts with 32 Pioneer ACOs, which are paid under a new model that includes bonuses and penalties for performance on quality and cost-control targets. The Pioneers were the first to test the payment model under the Patient Protection and Affordable Care Act and were followed by Medicare's less-ambitious Shared Savings Program, which has 220 ACOs and continues to expand.