Medicare's Pioneer program down to 19 ACOs after three more exit

Three more accountable care organizations dropped out of Medicare's Pioneer program, which was designed to test the payment and delivery model with a small group of elite providers deemed best prepared to handle the operational demands and financial risks. 

The Franciscan Alliance, Genesys PHO and Renaissance Health Network have exited the program, which is now in its third year. In August, Sharp HealthCare, San Diego, announced its decision to pull out after determining “the model was financially detrimental” despite the ACO's performance managing quality and healthcare use.

The Pioneer program was Medicare's first test of accountable care under the Patient Protection and Affordable Care Act, designed and administered by the CMS Innovation Center. It launched in 2012 with 32 organizations willing to accept potential losses with the goal of earning bonuses tied to performance on quality measures and their ability to slow health spending. Nine participants dropped out after the first year—seven of them switched to the Medicare's larger and less risky accountable care initiative, the Shared Savings Program.