On Friday, May 20, the Centers for Medicare & Medicaid Services published a notice in the Federal Register soliciting applications for a planned 30 slots reserved for “ACO pioneers.” Reading much like a job description, CMS’ notice identifies both the track record and the goals that will be evaluated to measure future performance.

CMS is looking to create a “dream team” of accountable care organizations, essentially providing another route for those entities that were held up as models for the creation of the ACO program to blaze the trail for others to follow.

CMS’ ideal candidate:

• Has a demonstrated track record of coordinating care while being subject to financial risk for the cost of the care provided;

• Is willing to serve as a beacon for those who seek to attain improvements in both financial and clinical performance; and

• Has the ability to modify behavior in response to financial and clinical data.

The successful candidate’s performance will be evaluated based upon the progress attained in achieving the following goals:

• The ability to transform quickly from fee-for-service to value-based coordination of care and improved outcomes;

• Demonstrating that ACOs can prosper under multiple governance structures (e.g., physician-driven) and diverse service areas (e.g., rural); and

• Proving that financial risk can be successfully managed for Medicare and non-Medicare patients alike.