resource Medicaid Accountable Care Organization Resource Center: Federal and State Policy Guidance States and the federal government have addressed issues surrounding the development of Medicaid ACO programs through policy papers, regulations,...

resource Medicaid Accountable Care Organization Resource Center: Payment Structure An ACO’s payment structure ties provider compensation to health outcomes — unlike the traditional fee-for-service model, which pays providers...

resource Medicaid Accountable Care Organization Resource Center: Quality Metrics An ACO program must monitor quality metrics to both ensure high quality care as well as confirm that ACOs...

resource Medicaid Accountable Care Organization Resource Center: Working with Providers, MCOs, and Consumers ACOs are a new business model and the existing stakeholders in a given environment must be brought on board...

resource Medicaid Accountable Care Organization Resource Center: Broad Scope of Services Researchers and policymakers increasingly recognize the impact of factors beyond physical health on health outcomes — including housing, social...

resource Medicaid Accountable Care Organization Resource Center: General Design An ACO program is designed to make providers accountable for the true costs of their patients’ care.  The resources...

resource Managed Long-Term Services and Supports Rate-Setting Resource Center: Risk Adjustment for Functional Status Advanced approaches to setting MLTSS rates — such as when and how to risk adjust rates based on functional...

resource Managed Long-Term Services and Supports Rate-Setting Resource Center: Foundational Concepts Developing and refining MLTSS payment rates requires an understanding of certain foundational concepts. The resources in this section provide...

resource Managed Long-Term Services and Supports Rate-Setting Resource Center: State Policy and Operational Considerations Rate-setting for Medicaid MLTSS programs is a complex undertaking. The resources in this section can help states understand the...

resource Managed Long-Term Services and Supports Rate-Setting Resource Center: Federal and Professional Guidance This section includes guidance from the Centers for Medicare & Medicaid Services (CMS) and Actuaries Standards Board to help...

resource Practice Transformation Assistance in State Innovation Models The federal State Innovation Model (SIM) initiative is striving to achieve statewide multi-payer care delivery and payment reforms for roughly 80...

April 2017

resource Using Community Health Workers and Volunteers to Reach Complex Needs Populations To effectively reach individuals with complex medical and social needs, health care delivery systems are increasingly incorporating alternative roles...

April 2017