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Delaware launching Accountable Care Organizations to serve Medicaid patients

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Delaware is launching four Accountable Care Organizations (ACO) to serve Medicaid patients.

The ACOs are networks of medical providers that mean to coordinate care between practices up and down the state to try to keep Medicaid patients healthy – thereby reducing how much it costs to care for them. The practices in the networks agree to share responsibility for patient outcomes and the cost of patient care

This value-based care model has seen some success for Medicare patients in the state. Delaware practices in the ACO Aledade, for example, were able to save Medicare more than $18 million in 2019. And ChristianaCare’s Medicare ACO, eBrightHealth, has been able to save more than $18 million in patient care over the past four years.

Dr. Rose Kakoza is medical director for ChristianaCare’s new Medicaid ACO, Delaware Medicaid Quality Partners. 

“We really see this ACO model as an opportunity to optimize our care delivery to the Medicaid population and really work to eliminate those healthcare disparities that we see in our community,” said Kakoza.    

Delaware’s Department of Health and Social Services (DHSS) has also approved Aledade to launch its ACO for Delaware Medcaid patients. Nemours is also starting one. The fourth ACO is a partnership between Saint Francis Healthcare and the Medical Society of Delaware.

The groups can now enter into agreements with the state’s two Medicaid managed care organizations (MCOs) – AmeriHealth Caritas Delaware and Highmark Health Options. The contacts require at least 5,000 Medicaid or Children’s Health Insurance Program (CHIP) recipients to enroll in the program through their primary care provider or MCO. They are expected to begin at the start of 2021, and run through the end of 2024.

In a statement, DHSS Secretary Molly Magarik called the new program, “a pillar of our work to change how health care is delivered and paid for in Delaware.”

Medicaid ACOs operate in about a dozen other states, according to DHSS.

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