States introducing accountable care organization (ACO) programs into an existing Medicaid managed care environment will need to assign responsibilities between ACOs and managed care organizations (MCOs). Successful delineation of responsibilities can support ACOs and MCOs in complementing one another and being better positioned to improve care delivery for Medicaid enrollees.

This tool, made possible by the Medicaid ACO Learning Collaborative, identifies five responsibilities that both ACOs and MCOs may share and outlines which entity may be better suited to perform each function. State Medicaid agencies, as well as ACOs and MCOs, can use the tool as a worksheet to help outline ACO/MCO roles and responsibilities. For more information on the relationship between ACOs and MCOs in Medicaid, please see: The Balancing Act: Integrating Medicaid Accountable Care Organizations into a Managed Care Environment.