Pioneer ACO Model

The Pioneer ACO Model is designed for health care organizations and providers that are already experienced in coordinating care for patients across care settings. It will allow these provider groups to move more rapidly from a shared savings payment model to a population-based payment model on a track consistent with, but separate from, the Medicare Shared Services Program. And it is designed to work in coordination with private payers by aligning provider incentives, which will improve quality and health outcomes for patients across the ACO, and achieve cost savings for Medicare, employers and patients.


Select anywhere on the map below to view the interactive version Pioneer ACOs mapped

There are 19 ACOs participating in the Pioneer ACO Model. (List)

To view an interactive map of this Model, visit the Where Innovation is Happening page.

Initiative Details

The payment models being tested in the first two years of the Pioneer ACO Model are a shared savings payment policy with generally higher levels of shared savings and risk for Pioneer ACOs than levels currently proposed in the Medicare Shared Savings Program. In year three of the program, participating ACOs that have shown a specified level of savings over the first two years will be eligible to move a substantial portion of their payments to a population-based model. These models of payments will also be flexible to accommodate the specific organizational and market conditions in which Pioneer ACOs work.

Quality and financial results are provided for Performance Year 1 (2012), Performance Year 2 (2013) and Performance Year 3 (2014):

The results provide the total number of beneficiaries aligned to a given Pioneer ACO, benchmark expenditures to which ACO expenditures are compared, actual ACO expenditures and payment from CMS to the ACO as shared savings or paid from the ACO to CMS as shared losses. In order to receive savings or owe losses in a given year, ACO expenditures must be outside a minimum corridor set by the ACO's minimum savings rate (MSR) and minimum loss rate (MLR). If savings/loss is within this corridor, no payment is made to the ACO or owed to CMS. If the Gross Savings/Losses percentage is outside this corridor, then the ACO splits the overall savings/loss with CMS.

Additional Information

General Information

Beneficiary Enhancements

Performance Results

Financial Methodology and Payment Information

Press Releases