Article archive / December 1, 2016
Originally published: . Volume 7, No. 12. Source pages: 5.
Dept of Health Issues RFI for Provider-Led Accountable Care Organizations in Medicaid
The Louisiana Department of Health (formally the Louisiana Department of Health and Hospitals) is requesting information for Provider- Led Accountable Care Organizations.
“ACOs must focus on bettering the overall health of the population they serve. This is achieved through better-coordinated care as well as population health initiatives,” noted the authors.
In a November 4 announcement, Frank Opelka, Medicaid Program Manager wrote, “As part of its efforts to modernize payment mechanisms for Louisiana’s Medicaid program and its delivery system features, to shift from paying for volume to paying for value and to improve health care quality and outcomes, the Louisiana Department of Health (LDH) is seeking comment on the possibility of inviting provider-led managed care plans to participate in the Healthy Louisiana Medicaid managed care program as Accountable Care Organizations (ACOs).”
Responses are due by 5 pm on December 9, by email.
According to the Request for Information (RFI), LDH is seeking community input on the development of requirements for the provider led ACOs. The authors of the RFI noted that they expect that ACOs would be organizations or groups of organizations with a hospital, a federally-qualified health center, or a rural health clinic. These organizations would be owned, governed and led by Louisiana health care providers and be capable of providing, “… for the case management and primary and secondary care needs of no fewer than 10,000 Medicaid beneficiaries annually,…”
“ACOs must implement ‘meaningful and identifiable’ reforms in patient engagement and care delivery, to demonstrate a significant effort to improve quality and value of patient care.
“ACOs must incentivize a realistically achievable shared savings mechanism for their providers to combat volume-driven care delivery,” and also “measure and report quality metrics that are readily accessible to its patients and governing board.”
The Medicaid Quality Committee, noted the announcement, includes medical directors of the managed care organizations (MCO), and seeks to improve and maintain the quality of the state's Medicaid Program by contributing specialized knowledge and experience to that available within the Medicaid Program. The aim is to provide a two-way channel of communication with the individuals, organizations and institutions in the community that, with the Louisiana Department of Health, receive, provide and/or pay for medical care and services. This is not a policymaking board; the committee's functions are advisory only, authors noted.
This article is part of a historical newspaper archive. Read the original issue for its original layout, photographs and graphics.