Accountable Care Entities (ACEs)

Program Location: 
Springfield, IL
Payer Type: 

Accountable Care Entities (ACEs), a new model of an integrated delivery system, were authorized by Illinois state law  (Public Act 98-104 (pdf) in July 2013.  As the fourth model providing “care coordination services” for Medicaid clients, ACEs will incorporate the following elements:

  • To be organized by providers and will coordinate a network of Medicaid services
  • Will initially enroll children and their family members, with an option to enroll "newly eligible" adults under the Affordable Care Act
  • Will each be large enough to have impact for a population of at least 40,000 clients in Cook County, 20,000 in collar counties, and 10,000 downstate
  • Will include, at a minimum, the following types of providers: primary care, specialty care, hospitals, and behavioral healthcare
  • Will have a governance structure that includes each type of provider
  • Will build an infrastructure to support care management functions among the providers in the network, such as health information technology, risk assessment tools, data analytics, and communication with Medicaid members
  • Will be on a three-year path to a new payment structure different from the current fee-for-service: shared savings within the first 18 months, partial risk after 18 months, and full risk after three years

Nine applicants are working to become ACEs on or after July 1, 2014.

Related News & Resources

Payment Model: 

ACEs are incorporating a new payment structure different from the current FFS including shared savings within first 18 months, partial risk after 18 months, and full risk after three years.

In the first 18 moths of operation, Medicaid will continue to reimburse claims through traditional FFS, but will also provide ACEs with an additional care-coordination fee of $9.00 PMPM. In the second 18 months, providers will incur full financial risk under an undetermined capitated payment

Last updated July 2015
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