Accountable Care Collaborative
The Department is interested in how to better contain health care costs while improving the overall health and functioning of the clients we serve. We have learned over the years that higher health care spending is not necessarily associated with higher quality health care. Health care services for our Medicaid program are typically delivered in the traditional fee-for-service model, which does not always support coordinated care and the appropriate utilization of services.
The Accountable Care Collaborative (ACC) is a client-centered approach to managed care that is focused on delivering efficient and coordinated care that improves the overall health of clients. This model of care differs from capitated managed care by investing directly in community infrastructure to support care teams and care coordination and creates aligned incentives to measurably improve client health and reduce avoidable health care costs.
The ACC makes the people and organizations that actually provide the care accountable for the quality and the cost of that care. Previous health care reform initiatives involved insurers and made them ultimately accountable. The concept driving the ACC is that it is providers, not insurers, who are in the best position to make the changes that will address the cost and quality problems resulting from our system of fragmented care, variation in practice patterns and volume-based payment systems. Local communities are ideally positioned to know the unique needs and characteristics of their clients and the resources available within their community to not only assure access to health services, but to provide those social and program supports that will improve health outcomes.
The ACC provides the framework within which other health care initiatives can thrive such as the medical home, health information technology, and payment reform. While the ACC can be structured in a variety of ways, there are characteristics that are essential to the success of the ACC:
• Must provide or manage the continuum of care as a real or virtually integrated delivery system
• Must have a large enough number of clients to support comprehensive performance measurement
• Must be capable of prospectively planning budget and resource needs
• Must be able to develop and organize provider network
• Must be able to support Web-based provider health information
The Accountable Care Collaborative is part of the Medicaid reform effort, and is envisioned to consist of a statewide data and analytics organization and a number of regional care coordination organizations. These regional organizations will be charged to offer care-coordination services and to support the local participating providers and clients in the regions. The Accountable Care Collaborative Request for Information (RFI) was posted in July 2009 in order to get more information from stakeholders to further develop the model. The Request for Proposals will go out in early 2010, and the Department will implement the program later in 2010 starting with 60,000 clients. If the program demonstrates success, it will be expanded in later years. All aid categories will be eligible for enrollment in the program.
Accountable Care Collaborative Fact Sheet
Accountable Care Collaborative Questions and Answers