State Accountable Care Activity

The National Academy for State Health Policy is tracking state efforts to lead or participate in accountable care models that include Medicaid and Children’s Health Insurance Program populations. Accountable care models aim to address lack of care coordination and wide disparities in cost and quality of care in the U.S. health care system, perpetuated by the prevailing fee-for-service payment method, through shared incentives to manage utilization, improve quality, and curb cost growth.

State efforts to advance accountable care models vary considerably. However, for the purposes of this map, a set of three core characteristics and capabilities, consistent across designs, is needed: 

  • Organizations or structures should assume responsibility for a defined population of patients across a continuum of care, including across different institutional settings.  
  • Participants should be held accountable through payments linked to value, emphasizing dual goals of improving quality and containing costs.  
  • Accountability should be facilitated by reliable performance measurements that demonstrate savings are achieved in conjunction with improvements in care.
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