Health System Leaves Pioneer ACO Model; Looks To Remote Monitoring Technology

By Megan Williams, contributing writer

Dartmouth-Hitchcock Medical Center, a premier member of one of the largest health systems in the Northeast, has announced that it will be abandoning the Pioneer ACO (accountable care organization) program, according to HealthcareITNews.

The system lost more than $3 million over the last two years under the CMS value-based model. This was a drop from positive earnings in its first year in the program. According to Robert A. Greene, MD, executive vice president and chief population health management officer for the New Hampshire ACO, “We did give CMS our official notice of withdrawing from the Pioneer program for the calendar year ...We looked at our performance and looked at the 2015 performance and we saw the same thing, another penalty. It seemed unsustainable from a financial point of view.”

According to Home Healthcare News, the Pioneer program has lost almost half of its original participants. This though, doesn’t mean that Dartmouth-Hitchcock has completely abandoned ACOs. The system has plans to sign on with CMS’s Next Generation ACO program which begins January of next year. The agency will likely be announcing participants soon.

CMS has already approved Dartmouth-Hitchcock’s application to the Next Generation program, with the system being scheduled to receive its dollar target this fall. If they agree with the target, Dartmouth-Hitchcock will only have to sign the contract to begin participation in the Next Generation Model.

Other Providers Considering The Same Move

Maine provider, Beacon Health has also been considering leaving Pioneer and moving over to Next Generation, but is currently waiting for more information from CMS.

The Next Generation Model will be made up of three performance years on the front end and will give participants the option to extend their participation twice in one-year increments. One of the key benefits that Next Generation offers over Pioneer is providers receiving their benchmark right out of the gate. It also gives them tools to engage beneficiaries, according to Greene. For example, providers will be able to issue a waiver to skip the three-day inpatient requirement before sending a patient to a skilled nursing facility … something not possible under fee-for-service models. The Next Generation model also makes room for post-hospitalization enhanced home health visits. According to Greene, “Add those things up, it means people will starting knowing Dartmouth-Hitchcock ACO is their care network. It will do more for them. They will continue to come to us. It will help us provide coordination.”

The Role Of Remote Monitoring

Pioneer ACO members who have been successful cite remote sensing capabilities as one of the primary reasons they met the goals they did, listing the ability to engage with patients during severe low temperatures and over long distances. Dartmouth is optimistic about using telehealth and remote sensing in their new, integrated system to amplify cost savings.

Going Deeper

To learn more about ACOs and their needs around technology, please read ACOs And Their Tech Needs: Where VARs Come In.