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Accountable Care Firm ‘pioneers’ feeling skittish about following stage of program’s implementation The providers who are taking part in this health law effort to control costs and improve quality are nervous about the second year's focus on accountability. The Washington Post: Hospitals Want To Delay A Key Obamacare Program In 2011, the Obama administration settled on 32 health care systems, scattered across the country, to lead the Affordable Care Take action's many ambitious cost-control effort. For the past year, the Pioneer ACOs have received payments for reporting data on the 33 metrics just, which includes data on how many sufferers receive mammograms or end up back in the hospital 30 days after their discharge dapoxetine 60 mg .