Pioneer ACOs perform fewer low-benefit services

The CMS' Pioneer accountable care organizations are reducing the number of services they provide to patients that have minimal clinical benefit, a study in JAMA Internal Medicine found.

The results suggest that the ACO program is having its intended effect. By changing the incentives for how healthcare services are reimbursed, the CMS is pushing providers to change the way they practice medicine.

The Pioneer program is the riskier of the CMS' two ACO initiatives because healthcare providers are on the hook for financial losses if they fail to reduce the cost of care. The program also sets quality benchmarks that providers must meet.

“Although adjusting practice to lower costs is a stretch from physicians' traditional role, the well-being of their patients and their communities now depend on it,” wrote Dr. Arnold Milstein, director of Stanford University's Clinical Excellence Research Center, in an accompanying editorial.

Researchers at Harvard Medical School looked at 31 healthcare services that were deemed of little clinical benefit, such as certain cancer screenings and certain preoperative, imaging and cardiovascular tests.

They measured service count and spending per 100 Medicare beneficiariesbefore the Pioneer program began, from 2009 to 2011, and in the first year of the program, which started in 2012.