Funder: The Commonwealth Fund

July 2015 | Technical Assistance Tool


Medicaid accountable care organizations (ACOs) have a uniform goal of providing higher quality, more cost-effective care for safety net populations. However, Medicaid ACO governance models vary widely depending on the local health care market, community stakeholders, and unique financing issues.

As part of the Medicaid Accountable Care Organization Learning Collaborative, made possible by The Commonwealth Fund, the Center for Health Care Strategies (CHCS) reviewed existing state Medicaid ACO models and identified key differences across programs.  Key areas to consider for governance models include whether programs are:

  • Provider- or payer-led;
  • Existing or newly created organizations; and
  • Inclusive of community stakeholders.

This resource examines the governance structures, including community involvement, of ACO programs in nine states: Colorado, Iowa, Illinois, Maine, Minnesota, New Jersey, Oregon, Utah, and Vermont. Lessons from these states can inform additional states in designing a Medicaid ACO approach to meet the needs of their communities.