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Letter to the Editor
Accountable care
  1. Joshua A Hirsch1,
  2. Thabele M Leslie-Mazwi1,
  3. Philip M Meyers2,
  4. Gregory N Nicola3,
  5. Laxmaiah Manchikanti4,5
  1. 1NeuroEndovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
  2. 2Departments of Radiology and Neurological Surgery, Neurological Institute of New York, Columbia University, College of Physicians & Surgeons, New York, New York, USA
  3. 3Hackensack University Medical Center, Hackensack, New Jersey, USA
  4. 4Pain Management Center of Paducah, Paducah, Kentucky, USA
  5. 5Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, Kentucky, USA
  1. Correspondence to Dr Joshua A Hirsch, NeuroEndovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; Hirsch{at}

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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 …

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