Core Considerations for Implementing Medicaid Accountable Care Organizations

Leading-edge states across the country are exploring the potential of accountable care organizations (ACOs) to drive improvements in quality, delivery, and cost-effectiveness for Medicaid populations. With support from The Commonwealth Fund, and additional funding from the Massachusetts Medicaid Policy Institute, the Center for Health Care Strategies (CHCS) designed Advancing Medicaid Accountable Care Organizations: A Learning Collaborative to help state pioneers launch Medicaid ACO models. Through this effort, CHCS is assisting seven states — Maine, Massachusetts, Minnesota, New Jersey, Oregon, Texas, and Vermont — on advancing the development and implementation of Medicaid ACOs.

Drawing from the experiences of these innovator states, 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 the Medicaid program and the challenges inherent in improving care for vulnerable, low-income populations. Other issues are common across all payers, signaling opportunities for multi-payer collaboration and alignment.

RELATED RESOURCE

High-Performance Health Care for Vulnerable Populations: A Policy Framework for Promoting Accountable Care in Medicaid  This report, prepared for the Commonwealth Fund by Deborah Bachrach and colleagues at Manatt Health Solutions, focuses on the Medicare Shared Savings Program as an example of how Medicaid might build on delivery system and payment reform programs in Medicare. The report proposes a policy framework for states to create ACOs for their Medicaid populations.