NJ – Study Reveals Findings on State Medicaid ACO Demonstration

March 2017~

The Rutgers University, Center for State Health Policy has released a ‘Year 1’ report of the New Jersey’s Medicaid ACO demonstration, with an assessment of ACO operations and care management strategies.

The report assessed ACO operations and care management strategies from July 1, 2015, to June 30, 2016 and covered the experience of the three certified ACOs in NJ: the Camden Coalition of Healthcare Providers, Healthy Greater Newark, and the Trenton Health Team.

To better understand the specific functioning of the certified ACOs, additional interviews were conducted with ACO applicants from Paterson and New Brunswick who were not certified but had indicated plans to pursue accountable care activities outside of the Demonstration.

According to Rutger’s analysis of interview transcripts generated the following five major themes:

1. Overall, the ACO construct is viewed as part of a larger community health improvement strategy with components and organizations outside of the ACO itself.
2. ACOs are developing strategies to engage, and prove their value to, largely skeptical MCOs.
3. ACOs continue to define and rethink the most important patient subgroups to target for focused intervention.
4. ACOs are developing precisely targeted strategies to engage providers and improve targeted subsets of quality measures.
5. ACOs rely on multiple and unstable funding sources to cover costs and retain staff. Uncertain funding limits longer term planning

The report found the Camden ACO to be the most developed with well-defined care coordination strategies and shared savings contracts with two Medicaid MCOs, the Trenton ACO negotiated a contract with one Medicaid MCO and has made progress with data analytics and provider engagement. And the Newark ACO is the least developed and is focused on building infrastructure, data analytics and provider and social service engagement.

Source(s): Rutgers University Center for State Health Policy, March 2017; Center for Health Care Strategies, March 2017; NJ HCQI, March 2017; The Nicholson Foundation, March 2017;