Across the country, states are exploring the viability of Medicaid accountable care organizations (ACOs) that align provider and payer incentives to focus on value instead of volume, with the goal of keeping patients healthy and costs manageable. Currently, 12 states have active Medicaid ACO programs, and at least 10 more are pursuing them.

This fact sheet from the Center for Health Care Strategies (CHCS) walks through current progress for Medicaid ACOs. It provides a definition for ACO and describes how emerging state 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.


This fact sheet was developed through CHCS’ Medicaid Accountable Care Organization (ACO) Learning Collaborative, a national initiative made possible by The Commonwealth Fund. The collaborative is helping states advance new ACO models designed to improve patient outcomes and control costs by shifting accountability for risk and quality to providers.