An Accountable Care Entity (ACE) will be a new Illinois model of an integrated delivery system. This will be the fourth model providing “care coordination services” for Medicaid clients, which now includes Managed Care Organization (MCO), Managed Care Community Network (MCCN) and Care Coordination Entity (CCE). This infographic provides a great overview of the system so far.
The ACE will have these elements:
- Will be a provider-organized network of care -- providers working together collaboratively
- Will be large enough to have impact for a population: initially children and their family members in Illinois Medicaid, at least 40,000 in Cook County, 20,000 in collar counties, 10,000 downstate
- Will have at a minimum the following types of providers: primary care, specialty care, hospitals, and behavioral healthcare; will have a governance structure that includes each type of provider and works to create a shared culture of collaboration/transformation
- Will build an infrastructure to support care management functions among the providers in the network, such as health information technology, risk assessment tools, transparent data and data analytics, communication with Medicaid members, etc.
- Will work toward a new payment structure different from the current fee-for-service: shared savings within first 18 months, partial risk after 18 months and full risk after 3 years, which means capitated payments with financial incentives for the providers within the network
The initial population assigned to ACEs will be children and family members (and likely newly eligible Medicaid clients under the Affordable Care Act.)
For more information check out the HFS Care Coordination Site
Health & Disability Advocates