Section I: General Design
An ACO program is designed to make providers accountable for the true costs of their patients’ care. The resources in this section provide general information on ACO programs, as well as key considerations for policymakers to address in designing a Medicaid ACO program.
Medicaid ACOs: State Update (Updated February 2018) – This fact sheet describing how emerging state Medicaid ACO programs are seeking to drive accountability through three key activities: (1) implementing a value-based payment structure; (2) measuring quality improvement; and (3) collecting and analyzing data. It also provides a glimpse of some early state successes.
The History, Evolution, and Future of Medicaid Accountable Care Organizations (February 2018) – This brief examines how Medicaid ACO programs have evolved over time, highlights program results to date, explores key lessons from early adopters, and shares considerations to further the development of effective ACO approaches moving forward.
Levers of Successful ACOs (November 2017) – This report, from the Health Care Transformation Task Force, shares insights from interviews with ACOs to assess structures and strategies that led to their success. Common themes emerged in three major categories: (1) achieving high-value Culture; (2) proactive population health management; and (3) structures for continuous improvement.
Program Design Considerations for Medicaid ACOs (February 2016) – This brief examines the early experiences of state Medicaid ACO programs and offers considerations for additional states. It outlines three core steps to guide states in developing an ACO approach: (1) evaluate the current environment; (2) define program goals and framework; and (3) develop a structural model.
Designing a Medicaid ACO Program: Insights from Trailblazing States (February 2016) – This webinar explored key Medicaid ACO design considerations through the experiences of existing programs. The discussion featured perspectives from two different state ACO models: Colorado’s Accountable Care Collaborative program and Minnesota’s Integrated Health Partnership demonstration.
Accountable Care Organizations: Looking Back and Moving Forward (January 2016) – This brief examines how ACOs can build upon initial successes and informs policymakers, researchers, and foundations about key considerations to further the development of effective ACO approaches across health care.
Medicaid ACO Programs: State Profiles (October 2015) – This brief summarizes core ACO characteristics and profiles how nine states that have incorporated these elements into their Medicaid ACOs. For each state, it outlines key ACO infrastructure; details unique payment, quality, and data approaches; and spotlights one of the state’s Medicaid ACOs.
Comparing State Medicaid ACO Governance Models (July 2015) – This technical assistance tool examines the governance structures, including community involvement, of ACO programs in nine states.
Medicaid ACOs: Program Characteristics in Leading-Edge States (February 2014) – This technical assistance tool outlines how each state has configured key ACO program features including: governance; provider eligibility; covered populations; scope of accountable services; required functions; payment models; and quality measures.
Planning for Accountability: Emerging Medicaid ACO Models and Key Issues for States (October 2013) – This webinar explored emerging Medicaid ACO models, including state trends, best practices, and lessons learned. Speakers from the Minnesota Health Care Delivery System demonstration and the Massachusetts Primary Care Payment Reform initiative outlined program components and key program decision points.
Core Considerations for Implementing Medicaid ACOs (November 2012) – This issue brief outlines 10 core considerations to help guide the development and implementation of Medicaid ACO approaches. Some of the considerations are unique to Medicaid programs, while others are common across all payers, signaling opportunities for multi-payer collaboration and alignment.
ACOs in Medicaid: Emerging Practices to Guide Program Design (February 2012) – This brief highlights emerging best practices from state ACO activities across the country and summarizes safety-net ACO programs being developed in five states. It outlines key issues for federal and state agencies, health plans, providers, and communities to consider in designing ACO programs to serve low-income beneficiaries.
ACOs: Creating a Workable Approach for Medicaid (August 2015) – This issue brief outlines 10 key issues that Centers for Medicare & Medicaid Services (CMS) and states need to address in developing a future Medicaid ACO Program.