Briefs & Reports

State Levers for Improving Managed Care for Vulnerable Populations: Strategies with Medicaid MCOs and ACOs

Sharon Silow-Carroll
Jennifer N. Edwards, DrPH
Diana Rodin

HMA recently published a report detailing the 10 leading states’ strategies for using managed care to promote quality, cost-effectiveness, and better health outcomes for vulnerable Medicaid populations.

Authors examined Medicaid “levers” used with both licensed managed care organizations (MCOs) and new integrated delivery systems such as accountable care organizations (ACOs). After a thorough review, report authors concluded that state Medicaid programs have a significant opportunity to play an essential leadership role in promoting greater accountability for quality and cost of care through contracting requirements, incentives, technology supports, and engaging MCOs, ACOs, and other stakeholders. States can engage these groups to develop and implement new payment and delivery strategies, share best practices and align quality improvement initiatives. In fact, doing so holds great promise for improving quality, access, and cost-effectiveness of care for vulnerable populations.

The authors also concluded there’s plenty of room for MCOs and ACOs to not only co-exist in serving Medicaid populations, but interface as they’re moving in similar directions toward greater accountability among health care providers for quality and cost.

This work was supported by a grant from The Commonwealth Fund, a private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.