What is an ACO?
- Doctors, hospitals, and other health care providers who voluntarily come together to provide high quality care to Medicare patients.
What is the Pioneer ACO Model?
- The Pioneer ACO Model shows how particular ACO payment arrangements can best improve care and generate savings for Medicare.
- It also tests alternative program designs to inform future rule making for the Medicare Shared Savings Program
When does the Pioneer ACO Model:
- January 1, 2012
- When does it end?
- 3 years from January 1, 2012.
- How many ACOs are participating?
- 32 Organizations
How is the Pioneer ACO Model different from the Shared Savings Program?
- To view the list of ways the Pioneer ACO Model differs from the Medicare Shared Savings Program, see the link at the bottom of the blog post.
How is it different from the Advance Payment Model?
- Only available to ACOs participating in the Medicare Shared Savings Program.
Can an ACO Participate in both the Shared Savings Program and the Pioneer ACO Model?
How will payments to the Pioneer ACO work?
- Will follow a shared savings or losses experienced by Medicare for a specific set of beneficiaries.
What are population-based payments?
- Population-based payments are per-beneficiary per month payment amount intended to replace a significant portion of the ACO's fee-for-service (FFS) payments with a prospective payments.
How will beneficiaries be affected by the Pioneer ACO Model?
- Improves partnership between patients and doctors in making health care decisions.
Are beneficiaries required to participate in the Pioneer ACO Model?
- Competitive application review process
How did CMS select the ACOs participating in the Pioneer ACO Model?
- 160 letters of intent, 80 applications
To download the full PDF, please click the following link: Pioneer Accountable Care Organization (ACO) Model Program Frequently Asked Questions (FAQs).
For additional billing, coding and reimbursement resources, please click the following link: Medical Reimbursement, Inc. Resources Page.