White Papers

Medicaid ACO : Creating Another Approach to Population Management

Across the country, health purchasers are exploring the potential of accountable care organizations (ACO) to provide higher quality and more cost-effective care. Progress is being made for Medicare and commercial populations: the Brookings-Dartmouth ACO Pilot1 is developing commercial shared savings contracts with private payers; the Centers for Medicare & Medicaid Services (CMS) released a final ruling for a Medicare Shared Savings Program2; and the Center for Medicare and Medicaid Innovation is supporting a Pioneer ACO Model (32 approved for participation) for Medicare and multi-payer ACOs.

As a result of this Medicare activity, ACOs are also gaining ground in Medicaid. As Medicare, commercial payers, and providers begin the process of introducing ACOs within various markets, state Medicaid agencies, managed Medicaid organizations, and providers have also been evaluating various initiatives for their beneficiaries. As Medicaid prepares to expand coverage to an additional 16 to 20 million Americans in 2014, the program is rethinking how it delivers care, particularly for its highest–need, highest-cost beneficiaries.

In examining ACOs and Medicaid, this white paper covers:

  • The Focus on Patient-Centered Care
  • State ACO Initiatives and Structure
  • State Home Health Initiatives and Structure
  • State Medical Home Initiatives and Structure
  • Medical and Health Home Survey and Measurement Solutions

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