States around the country are actively beginning to pursue and lay the groundwork for ACOs at the state Medicaid level. These entities are set up and function much like other ACOs through savings sharing, best practices and quality reporting, but exist under the state’s auspices.
The Patient Protection and Affordable Care Act of 2010 does not expressly create Medicaid ACOs
Some policymakers view Medicaid ACOs as a vehicle to improve physician payments, enhance care coordination, and lower overall costs
Medicaid ACO pilots are taking hold in states around the country
UT and OR: Set to go live in 2012
NJ: Authorized by the state legislature, but needs regulatory authority
OK: Developing a Medicaid ACO framework
MA, MN, NC, OR, TX, ME & VT: Considering adoption
AZ, NY, TN: Could consider adoption given their familiarity with managing health delivery
A state’s history of involvement with managed care, existing care delivery models within Medicaid, and experience with low-‐income and chronically ill populations will affect a state’s willingness to establish a Medicaid ACO
Download this fact sheet from Greenway below to read more.