At deadline, a CMS spokesman had not responded to questions about the reasons for Gilfillan's departure or his subsequent plans. Tavenner's memo said only that Gilfillan will “move on to new opportunities at the end of June.”
“I think that he is going to be sorely missed,” said Tricia Nguyen, chief medical officer of the Banner Health Network, one of the Pioneer organizations. “He was very collegial, collaborative and understands the complexity” of accountable care.
The 32 ACOs, known as Pioneers, raised objections this year to quality targets that must be met to earn financial incentives. Ongoing talks between Innovation Center and Pioneer officials have not yet resolved the issue and last week a deadline for Pioneers to withdraw from the program was extended until July 15.
Nguyen raised concerns that transition could create delays or alter the course of the accountable care effort. But she praised Conway, whom she met briefly during a meeting with top CMS officials. “Rick's going to be missed,” she said. “Patrick is probably the second-best choice.”
William Chin, executive medical director of HealthCare Partners, agreed that the departure could stall the program as the incoming Innovation Center director learns the job and works to build the working relationship Gilfillan already established. “His ability to communicate created a degree of trust,” said Chin, who was scheduled to speak with Gilfillan at a health technology summit. Chin said Gilfillan earned health systems' respect.
Mike Donahue, vice president of network development and ACO activities for Eastern Main Health System, another Pioneer ACO, said Gilfillan displayed the political will to adapt to unexpected challenges that arose with adoption of the largely untested payment model. “All of this is an experiment,” he said. “What you may think is going to work flawlessly doesn't always work out that way.”
An incoming leader will also assume control of the Innovation Center as its initial ACO results become public, which will create a challenge to either capitalize on early good news or respond publicly to disappointing results, said Stephen Shortell, dean of the University of California, Berkeley, School of Public Health and a professor of health policy, management and organization behavior. Shortell, who studies accountable care, is also a proponent of the payment model.
Accountable care officials praised staff of the Innovation Center and said organizational depth would help during the transition.