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CMS Announces New ACOs for Dual Eligible Beneficiaries

Last week the Centers for Medicare and Medicaid Services (CMS) announced the Medicare-Medicaid Accountable Care Organization (ACO) Model.  This new initiative is designed to improve quality of care and lower costs for beneficiaries who are enrolled in both Medicare and Medicaid.

Under the current model, beneficiaries who are Medicare-Medicaid enrollees may be attributed to ACOs. However, Medicare ACOs often do not have financial accountability for the Medicaid expenditures for those beneficiaries. The new model allows Medicare Shared Savings Program ACOs to take on accountability for the quality of care and both Medicare and Medicaid costs for Medicare-Medicaid enrollees.

CMS is currently accepting letters of intent from states that wish to work with CMS to design certain state-specific elements of the model. CHAP will monitor this story and provide updates as they are made available. 

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