States interested in using an accountable care organization (ACO) model for Medicaid populations must think critically about which metrics are best-suited to promote enhanced access and care coordination and encourage provider accountability for these outcomes. There is considerable variety in state Medicaid ACO measurement approaches related to access, quality, clinical, and cost goals. Quality measure requirements for ACOs can range from simple collection and reporting to advanced expectations involving achievement thresholds, benchmark comparisons, and/or rates of improvement over time. Methodologies to calculate performance-based payments can range similarly in complexity.
This technical assistance tool, a product of CHCS’ Medicaid ACO Learning Collaborative and made possible through support from The Commonwealth Fund, outlines the quality measurement approaches of eight states — Maine, Massachusetts, Minnesota, New Jersey, Oregon, Rhode Island, Utah, and Vermont — to inform states developing ACO programs. It presents the quality measures of each state’s Medicaid ACO program and key details, including measure domains, reporting requirements, and payment contingencies. This tool is an update to a resource that was originally published in September 2014.