Medicaid Accountable Care Organizations: State Update

Abstract

Many states have begun to implement Medicaid Accountable Care Organizations that align provider and payer incentives to focus on value instead of volume, with the goal of keeping patients healthy and costs manageable. Currently, 12 states have active Medicaid ACO programs, and at least 10 more are pursuing them.

Insights Results

Overview of model

Colorado’s Regional Care Collaborative Organizations (RCCOs) have reported $77 million in net savings for Colorado Medicaid. RCCOs have demonstrated lower rates of emergency department (ED) visits, high-cost imaging, and hospital readmissions for adult patients who have been enrolled in the program for more than six months

Maine’s Accountable Communities realized a savings of 3.15% in Medicaid costs, netting $4.56 million for MaineCare, the state’s Medicaid agency

Minnesota’s Integrated Health Partnerships (IHPs) have served 460,000 residents and saved nearly $213 million in the four years they have been operating. They have also reduced hospital admissions by 14% and emergency department visits by seven percent over that same time frame

Oregon reported that in FY 2015, all Coordinated Care Organizations (CCOs) showed improvement in quality measure performance, and 15 of the 16 earned 100% of their potential quality pool bonuses. In 2016, 62% of children were screened for risks of developmental, behavioral, and social delays, which is up from 41% improvement from 2011. In the past two years, Oregon also experienced a 19% increase in the number of women ages 18-50 who are using an effective contraception. These improvements have allowed the state to stay well within its two percent annual growth target

Vermont reported $15.7 million in savings due to its Vermont Medicaid Shared Savings Program (VMSSP) in the program’s first two years. Both of the state’s Medicaid Accountable Care Organizations (ACOs) improved their quality scores in the first two years.