States move forward with unique ACO models for Medicaid

September 1, 2012

Early efforts by states drive value with Medicaid ACOs, coordinated care.

Key Points

HEALTHCARE'S DIFFICULT times call for bold steps in value strategies, such as patient-centered medical homes, shared-savings and others.

In addition to the five states that are moving forward on Medicaid ACOs-Colorado, Minnesota, New Jersey, Oregon and Utah-another five could commit within the next six months, says Tricia McGinnis, senior program officer at the Center for Health Care Strategies (CHCS). The not-for-profit health policy resource center works with state and federal agencies to improve the quality of Medicaid programs and currently is working with 39 states.

"Data is a huge component of success," McGinnis says. "Providers often don't have that line of sight into the care they deliver that good data can bring."

Four out of five also have an active managed-care organization in the mix, according to CHCS research by McGinnis and policy analyst David Marc Small. Colorado and Oregon are developing hybrid payer/provider-led programs, while Minnesota has a combination of governance. Utah is exploring the payer-led model for its program in four populous counties around Salt Lake City.