Accountable care organizations (ACOs) are rapidly gaining a foothold across the country as a way to improve health care quality and control rising costs. States can facilitate Medicaid ACO model adoption by complementing the existing managed care infrastructure and clearly defining ACO and managed care organization responsibilities and performance expectations.
This new brief from the Center for Health Care Strategies can help guide state Medicaid agencies in successfully implementing ACOs within a managed care environment. It is a product of Advancing Accountable Care Organizations in Medicaid: A Learning Collaborative, which was made possible by The Commonwealth Fund and the Massachusetts Medicaid Policy Institute, a program of the Blue Cross Blue Shield of Massachusetts Foundation. Through the learning collaborative, ACO innovators from seven states – Maine, Massachusetts, Minnesota, New Jersey, Oregon, Texas, and Vermont – have gathered to accelerate ACO program development and address key issues.
This brief identifies many of the considerations facing states that are seeking to implement ACOs in a managed care context, including:
- Essential operational decisions;
- Potential areas for alignment across payers;and
- Delineation of ACO and managed care organization responsibilities to avoid duplication of services.