So last week it was all doom and gloom about Pioneer ACOs.
The buzz in health care wonkdom was all about 9 of the 32 organizations defecting from a program supposedly designed for the best and brightest of American health care organizations — with maybe more to follow. Accepting downside risk was just too perilous. Lags in getting data from Centers for Medicare & Medicaid Services (CMS) were undermining cost and quality control efforts. And the contradiction of being responsible (aka accountable) for the costs of Medicare enrollees but having no direct control over where they receive care — a central feature of the ACO model — was simply untenable.