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February 2018

Why Medicaid Accountable Care Organizations Fail and How They Can Succeed

Author Affiliations
  • 1American Academy of Pediatrics, Mission Viejo, California
JAMA Pediatr. 2018;172(2):107-108. doi:10.1001/jamapediatrics.2017.4162

The Patient Protection and Affordable Care Act (ACA) of 2010 implemented health care reform by increasing access to health insurance through subsidies and Medicaid. The ACA standardized health insurance benefits and supported transforming fee-for-service payment to models of value-based payment.

The triple aim of improving the experience of care and the health of populations while reducing cost of care became the call to action of health care reform. Accountable care organizations (ACOs), which accept responsibility for the care, health, and cost of a population, began in many health care organizations.1 The Centers for Medicare & Medicaid Services developed measures and payment models for Medicare beneficiaries. Hospital systems and other institutions developed plans to redesign primary care, implement population-based risk stratification and management, collect quality health indicators, and monitor hospital admissions, readmissions, and emergency department visits.2

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