AJMC September 9, 2022
This article presents a detailed descriptive analysis of how Massachusetts and Minnesota implemented Medicaid accountable care organization (ACO) models for their managed care population.
ABSTRACT
CMS aims to transition most Medicaid beneficiaries into accountable care relationships in the coming years. With more than 70% of Medicaid beneficiaries enrolled in managed care, CMS cannot reach this goal if Medicaid accountable care organizations (ACOs) focus exclusively on the fee-for-service population, as most Medicare ACOs do. We used a case study approach focused on the experiences of Minnesota and Massachusetts implementing a Medicaid ACO model that includes managed care, with details on stakeholder engagement, beneficiary attribution, and payment methodologies. Massachusetts took an approach that significantly changed the managed care organization (MCO)–provider–enrollee relationship by...
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