Montefiore ACO - CMS Pioneer ACO

Program Location: 
New York City, NY
Payer Type: 
Medicare
Parent Program: 
Payers: 
Medicare

Reported Outcomes

Description: 

The Montefiore Pioneer Model Accountable Care Organization (ACO) is a program that provides certain beneficiaries of the original Medicare program access to enhanced care coordination programs and a focus on illness prevention and wellness.  The Pioneer ACO program is designed to test new models of healthcare delivery and payment and provide Medicare beneficiaries with higher quality care, while reducing expenditures through enhanced care coordination. In addition to Montefiore's three adult hospitals, its extensive primary care and specialty sites and its employed and affiliated community-based physicians, the Montefiore ACO includes providers from other healthcare organizations in the Bronx, Brooklyn and Staten Island.

Payment Model: 

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.

Cost Savings: 
  • 7% savings in the first year
  • gross savings of more than $96 million in the second year, compared to $87.6 million in 2012
Increased Preventive Services: 
  • Montefiore’s ACO made great strides in improving quality performance in key areas like depression screening and screening for risk of future falls.

Last updated August 2018
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