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Dartmouth-Hitchcock Latest ACO to Drop from Pioneer Program

October 23, 2015
by Rajiv Leventhal
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The Lebanon, N.H. based Dartmouth-Hitchcock Medical Center has unofficially become the 14th organization to drop out of the Centers for Medicare and Medicaid Services' (CMS) Medicare Pioneer Accountable Care Organization (ACO) program.

Dartmouth-Hitchcock gave CMS official notice of its departure from the program on Sept. 14, according to Robert A. Greene, M.D., executive vice president and chief population health management officer at Dartmouth-Hitchcock.

According to various media reports, the ACO incurred financial penalties from CMS over the past two years despite achieving quality benchmark scores. Specifically, reports say, CMS charged the medical center $3.6 million for exceeding its spending benchmark last year, and another $1.4 million for missing benchmarks in the prior year.

Rather than drop out of ACO models all together, Dartmouth-Hitchcock is instead looking to participate in CMS’s Next Generation ACO Model, set to begin on January 1, 2016. ACOs in the Next Generation ACO Model will take on greater financial risk than those in current Medicare ACO initiatives, while also potentially sharing in a greater portion of savings.

According to CMS data from August, in 2014, 15 out of the 20 Pioneer ACOs (75 percent) generated some savings in 2014, meaning that 25 percent of those in the Pioneer program generated no savings last year. What’s more, in the Pioneer ACO program, which began with 32 ACOs in 2012, but is now unofficially down to 18 after several organizations dropped out, 11 organizations generated savings outside a minimum savings rate and earned shared savings payments of $82 million. However, of the five Pioneer ACOs that generated losses in 2014, three generated losses outside a minimum loss rate and owed shared losses. These ACOs are paying CMS $9 million in shared losses.

Healthcare Informatics will have more in this story as it continues to develop.

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