- Dartmouth-Hitchcock Medical Center (DHMC) said it will withdraw from the Pioneer ACO program after losing more than $3 million over the past two years. It hopes to join CMS's Next Generation ACO model next year.
- The Pioneer model was designed for the most experienced health systems, allowing them to share in Medicare savings or face penalties if Medicare spending came in above benchmarks.
- Dartmouth-Hitchcock had losses for two years but had good quality scores. It owed $3.6 million for Year 3 spending above its benchmark and $1.4 million from Year 2, according to CMS. After reconciling the figures with CMS, the hospital owed $3.7 million.
The goal of ACOs is to coordinate beneficiaries' care and provide services more efficiently. However, in August, CMS released 2014 financial data showing ACOs have not saved the government money and recorded a net loss of $2.6 million to the Medicare trust fund, as reported by Kaiser Health News. A previous article in Healthcare Dive reported Medicare projections in 2011 estimated ACOs would save $10 million to $320 million in 2014.
The Next Generation model program consists of three initial performance years and two optional one-year extensions. Dr. Robert A. Greene, executive vice president and chief population health management officer for Dartmouth-Hitchcock, said the Next Generation model offers many benefits over Pioneer, such as more tools to engage beneficiaries.
For example, instead of a required three-day hospital stay before being eligible for skilled nursing, a waiver is available to send those patients directly to skilled nursing. Telehealth will be available between facilities and from facility to patients. In addition, remote sensing technology to monitor and manage healthcare in patients' homes will be a huge benefit in rural areas of New Hampshire.
CMS has approved the medical center's application for the Next Generation program and will provide its dollar target this fall. DHMC said it would only sign the contract if the target is agreeable.