Medicaid ACO Checklist for Advocates

Introduction

Medicaid Accountable Care Organizations (ACOs)have become more widespread as states look for innovative ways to improve health outcomes and control rising costs for Medicaid beneficiaries. However, as states move toward shifting financial risk to providers it is important that advocates play a central role in the design, implementation and oversight of Medicaid ACO programs, in order for these programs to achieve their potential for advancing person-centered and community-responsive care. It will be particularly important to monitor Medicaid ACO implementation in the new post-election landscape, as changes may be occurring with the Medicaid program at the federal level.

To guide advocates in this work, the Center for Consumer Engagement in Health Innovation provides in each section of this toolkit a list of questions to consider when assessing a state's Medicaid ACO program. These questions can help advocates assess Medicaid ACOs in a variety of settings that include but are not limited to stakeholder meetings, comments on RFIs and contracts, and review of member communications. While each of the components below are important to create a person-centered system of care, creating that type of system takes time; it is an evolving process. The most fundamental part of each component is to ensure that the consumer voice is present.

This work was supported by a grant from The Atlantic Philanthropies. We welcome feedback on how this checklist has helped to shape your state’s ACO program. Please contact healthinnovation@communitycatalyst.org.

Authored by: Danielle Garrett, Leena Sharma, Kris Wiitala

Members of the Center for Consumer Engagement in Health Innovation Team

April 2017

 

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