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
T here 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.
  • Alina Health (Minnesota and Western Wisconsin)
  • Atrius Health (Eastern and Central Massachusetts)
  • Banner Health Network (Phoenix, Arizona Metropolitan Area Maricopa and Pinal Counties)
  • Beacon, LLC (Central, Eastern, and Northern Maine)
  • Bellin Thedacare Healthcare Partners (Northeast Wisconsin)
  • Beth Israel Deaconess Physician Organization (Eastern Massachusetts)
  • Brown & Toland Physicians (San Francisco Bay Area, California)
  • Dartmouth-Hitchcock ACO (New Hampshire and Eastern Verrmont)
  • Fairview Health Systems (Minneapolis, Minnesota Metropolitan Area)
  • Heritage California ACO (Southern, Central, and Coastal California)
  • Michigan Pioneer ACO (Southeastern Michigan)
  • Monarch Healthcare (Orange County, California)
  • Montefiore ACO (New York City (the Bronx) and lower Westchester County, New York)
  • Mount Auburn Cambridge Independent Practice Association (MACIPA) (Eastern Massachusetts)
  • OSF Healthcare System (Central Illinois)
  • Park Nicollet Health Services Minneapolis, Minnesota Metropolitan Area)
  • Partners Healthcare (Eastern Massachusetts)
  • Steward Health Care System (Eastern Massachusetts)
  • Trinity Pioneer ACO, LC (Northwest Central Iowa)

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.

CMS announced the quality performance results for Pioneer Model ACOs in Performance Year 1 (2012) (PDF) and Performance Year 2 (2013) (PDF). The quality performance results provided reflect performance rates for 32 Pioneer ACOs for Performance Year 1 and 23 Pioneer ACOs for Performance Year 2 across 33 clinical quality measures. The Calendar Year 2012 and 2013 mean quality performance rate for each measure, across all Pioneer ACOs, is also provided.

Additionally, CMS announced the financial performance results (PDF) for Pioneer Model ACOs in Performance Year 1 (2012) and Performance Year 2 (2013).  The Gross Savings / Losses percentage and dollar amounts indicate the total amount of savings / loss achieved by the Pioneer ACO in the given performance year. If the Gross Savings / Losses percentage is within the ACO's minimum savings rate (MSR) or minimum loss rate (MLR), then the ACO neither receives shared savings nor pays shared losses. If the Gross Savings / Losses percentage is outside the ACO's MSR / MLR, then the ACO splits the gross savings / loss with CMS. Three ACOs selected to defer reconciliation until after the completion of Performance Year 3.

Additional Information

General Information

Beneficiary Enhancements

Performance Results

Financial Methodology and Payment Information

Press Releases