By Deborah Leyva

Link: JAMA

In 2012, CMS launched the Pioneer Accountable Care Organization model and the Medicare Shared Savings Program. The Pioneer ACO model is a more ambitious test of population health management that targets experienced organizations. This model is an attempt to test viability of Accountable Care organizations and their ability to reduce spending and improve the quality of care provided to beneficiaries.

A study reported in the May 4, 2015 edition of JAMA reviewed Medicare spending, utilization and CAHPS domain scores for Pioneer ACOs in 2012 or 2013. The objective of the study was to evaluate spending and utilization between beneficiaries aligned with Pioneer ACOs and other FFS beneficiaries.

The study was “based on the work of evaluation contractors for the Evaluation of CMMI Accountable Care Organization Initiative performed under Contract HHSM-500-2011-00019i/HHSM-500-T0002 with the Centers for Medicare & Medicaid Services (CMS). CMS provided access to the data to the evaluation contractors to perform analyses under the guidance of Drs Nyweide, Lee, and Cuerdon. In conjunction with the contractors, Drs Nyweide, Lee, and Cuerdon designed the study and helped with interpretation of the data.”

Data was obtained from CMS’ Chronic Conditions Data Warehouse. The CMS Chronic Conditions Data Warehouse (CCW) provides researchers with Medicare and Medicaid beneficiary, claims, and assessment data linked by beneficiary across the continuum of care. The following graph is an example of Medicare Chronic Conditions by Medicare Status Code for 2013.

 For more information about Accountable Care Organizations and the regulations that support them visit the ACO Survival Guide store. ACO Quality Checklist coming soon!


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