The Washington State Health Care Authority has announced two new accountable care organization (ACO) pilot projects required by state legislation (SB 6522) enacted earlier this year. The state legislation requires the pilots to be implemented by January 2012 and requires a report to the legislature by January 2013. The ACOs will be accountable for the overall costs and quality of the services they provide and may share in savings they achieve. The pilots combine a patient centered medical home model with payment incentives for local networks of providers and practitioners to invest in health information technology, to share health data, to coordinate care, and to improve treatment quality and outcomes. The pilots are to be evaluated by the Group Health Research Institute and a co-director of the University of Washington’s Center for Health Management Research. The federal health care reform law, which recognizes the potential of such innovations, provides for optional Medicaid coverage of medical/health homes beginning in January 2011 and a multi-state pediatric ACO demonstration project beginning in January 2012. 

About Tom Entrikin

A former policy specialist with the U.S. Health Care Financing Administration (now Centers for Medicare & Medicaid Services (CMS)), Tom Entrikin has vast experience providing technical assistance to states on Medicaid eligibility, coverage, and reimbursement; provider certification and enrollment; program integrity; recovery of third party liabilities; Medicaid Management Information System (MMIS) performance specifications and operations; interagency agreements; contracts with managed care organizations; and Medicaid waiver programs.

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