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Funding, contract questions surround NJ's Medicaid ACOs


New Jersey has just embarked upon a grand experiment to improve the delivery of healthcare to Medicaid beneficiaries, one that will require significant collaboration between the state and health insurers, according to NJ Spotlight. The state is now in year one of a three-year Medicaid accountable care organization (ACO) demonstration project, and by July its three Medicaid ACOs must present a plan that demonstrates how they will share any savings they achieve from coordinating the care of low-income residents.

But the ACOs' ability to achieve these savings depends upon adequate funding from either the state or insurers, a situation that worries Joan Randell, chief operating officer of the Nicholson Foundation, which has helped fund the launch of some ACOs. Without more outside funding, the ACO model could suffer in both the present and the future, she tells the publication. Their success also depends upon insurers executing contracts with them for care coordination or other services, she says, adding, "to state it bluntly … to not offer the Medicaid ACOs and lookalikes contracts is to not offer them a chance at success." Article