Accountable care

We recently published several articles on value-based approaches to providing neurointerventional care in JNIS.1–3 Soon after these three were published, McWilliams et al4 published an interesting article in the New England Journal of Medicine on the topic of accountable care. As we reviewed in our paper, there are several different types of Accountable Care Organizations (ACOs).1 The Pioneer program was the first Medicare ACO model and, quoting from our own article, "this model achieved only mixed results".5

The Pioneer model went live in 2012 with 32 experienced healthcare organizations. The good news was that change was significant and immediate: the Pioneer model generated program savings for Medicare and the majority of ACOs outperformed their counterparts in Fee For Service models for all 15 quality metrics in its first year. The challenge was that a sizeable minority found...

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