At least 11 states are adding initiatives resembling accountable care organizations to their Medicaid programs. And many providers who shied away from the Medicare ACO models are interested in the state versions, many of which lack sanctions for providers who fall short of quality and cost benchmarks.
State Medicaid ACOs cover a broad range of approaches that reflect the divergent private-sector arrangements and payment systems also referred to as ACOs. The Medicaid versions include some that state officials call ACOs but lack key components of the federal ACO models, as well as others that don't use the term but contain many core ACO features, such as tying provider payments to patient outcomes.
That may be because the label comes with both hype and a burden, said Xiaoyi Huang, assistant vice president for policy at the National Association of Public Hospitals and Health Systems. “Anyone can call something an ACO and not actually be it, or on the flip side no one wants to call it an ACO and they will call it their own thing,” she said. “You just have to figure out if that fits into this accountable care model.”