Medicaid ACOs

Description

The ACA introduced Accountable Care Organizations to Medicaid with the authorization of pediatric ACOs. Subsequently the growth of Medicaid ACOs has developed generically, influenced in large part by the state’s existing Medicaid program, its history with managed care and other delivery systems. In many states, Medicaid has a history of risk-based managed care; ACOs introduce shared savings and greater incentives.
 
In concept, Medicaid ACOs are similar to their Medicare counterparts. They are typically provider-led and involve an increased use of quality metric designed to focus on patient-centered care and outcomes.
 
Medicaid ACO and more traditional Medicaid managed care may look very similar. States continue to explore Medicaid ACOs and the opportunities to provide a Medicaid quality framework, to merge medical and behavioral health services (which may have been previously carved out), and to manage beneficiaries with multiple chronic conditions

Varies dramatically by state; mirrors populations covered by managed care

Physician Group; Health Plans