Adopting accountable care through the Medicare framework.

By enacting the Patient Protection and Affordable Care Act of 2010 (ACA), Congress provoked change in the status quo in American health care delivery and payment. Although challenged by conservative voices resistant to change, the ACA survived its recent constitutional challenge. Regardless of how Congress tries to amend the ACA in the future, one vestige of the ACA likely to remain at least in the marketplace, if not in the law, is the concept of accountable care. The ACA created two programs, the Medicare Shared Savings Program (MSSP) and the Pioneer Accountable Care Organization Model (“Pioneer”), which work in parallel to bring the concept of Accountable Care Organizations (ACOs) to the Medicare program. At its core, the accountable care model matches payment for care