Emerging Medicaid Accountable Care Organizations: The Role of Managed Care
This brief examines efforts by a number of states to set up Accountable Care Organizations (ACOs) within their Medicaid programs. An ACO is a provider-run organization in which participating providers are collectively responsible for the care of an enrolled population, and may share in any savings associated with improvements in the quality and efficiency of care. The structure of Medicaid ACO initiatives is influenced by individual states’ experience with managed care, other existing care delivery arrangements within Medicaid, and the challenges of serving low-income and chronically ill populations. Cost-containment also is a motivating factor, and states must balance short-term cost-containment pressures against the investments in partnerships and delivery system redesign necessary for the success of Medicaid ACOs over the longer term.
Policy Brief (.pdf)
also of interest
- Financial and Administrative Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS
- Medicaid at 50
- One Year into Duals Demo Enrollment: Early Expectations Meet Reality
- Faces of the Medicaid Expansion: Experiences and Profiles of Uninsured Adults Who Could Gain Coverage