Put me in the glass third-full camp.
The first-year results from Medicare's Pioneer accountable care organization pilot project showed all 32 of the provider participants met their quality improvement-reporting goals, but only 13 reduced costs—the ultimate goal of the program. The 669,000 beneficiaries in those 32 groups had aggregate healthcare costs that grew by only 0.3% compared to 0.8% for a comparable group of beneficiaries not in ACOs, according to the CMS.
Let's put those numbers in a broader context. That 0.8% is well below the 6.2% growth in Medicare spending in 2011 that the CMS actuaries reported in January. Even discounting for the growth in the overall Medicare population, healthcare spending on the elderly appears to be slowing sharply, as it has for the broader population. The success bar for ACOs just got a lot higher.
That's good news for the CMS, for taxpayers and for elderly patients. The question that ACOs ultimately have to answer, though, is whether that can also be good news for providers as they adapt to risk-based reimbursement models.