Delaware
Medicaid program name: Delaware DHSS Division of Medicaid and Medical Assistance (DMMA)
Medicaid ACO program name: Medicaid ACO Program (contracts with Diamond State Health Plan, DE’s Medicaid Managed Care Program)
Status: Active
Summary:
In 2014, CMS awarded the State of Delaware a State Innovation Model (SIM) grant, which included efforts to engage payers in total cost of care models. In 2020, DMMA created the state’s Medicaid ACO Program and authorized four Medicaid ACOs to serve the state’s Medicaid beneficiaries through contracts with the state’s two Medicaid managed care organizations. The four ACOs chosen include Aledade Delaware ACO, Delaware Care Collaboration, Delaware Children’s Health Network, and Delaware Medicaid Quality Partners ACO, and they have been authorized to negotiate with and enter into agreements directly with the state MCOs. ACO contractors will began providing services in July 2021, with agreements scheduled to run through 2024. A shared risk/shared saving model is expected, with incentives to encourage value-based care of high quality with financial incentives to moderate costs. Delaware’s Medicaid director, Steve Groff, stated that, “We believe that by working together, Medicaid ACOs and MCOs can better coordinate care for Delaware’s Medicaid and CHIP members, providing better health outcomes and lower costs. We look forward to working with the four authorized applicants and the MCOs to achieve these goals.”
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