Though accountable care organizations have been primarily launched in the Medicare space, the concept has been applied to Medicaid, where its prevalence is growing steadily, according to a whitepaper from Salt Lake City-based Leavitt Partners.
In an effort to address growing economic pressures and better coordinate patient care, 15 states total have passed Medicaid ACO legislation or have implemented ACO-like programs or pilots, Leavitt Partners reported.
The whitepaper, entitled "The Rise and Future of Medicaid ACOs," identifies the following five dynamics that will likely shape the future of Medicaid ACO growth in the upcoming years.
1. Providers' ability to manage risk. Managing Medicaid populations has its own set of unique challenges, but organizations' abilities to handle risk will determine the pace of adoption of this model of care for Medicaid populations.
2. Outreach and preexisting managed care infrastructure. Outreach efforts are critical to the success of this model of care and can be quite time consuming, especially in states without well-established infrastructure for managed care, according to Leavitt Partners.
3. Stakeholder acceptance or pushback. The degree to which stakeholders are open to the idea will affect how quickly Medicaid ACOs can be adopted. Seeking collaborations with stakeholders, providing comment periods and using other initiatives to engage stakeholders in the process can speed rollout efforts, according to Leavitt Partners.
4. State legislative and regulatory requirements. The timing of state-based initiatives, requirements or regulatory structures, including Medicaid expansion strategies, may impede Medicaid ACO adoption.
5. Data capabilities. The ability to efficiently use data analytics will ultimately affect the growth of Medicaid ACOs and their ability to manage the health of their populations, according to the report.
For more information, view the full report here.
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