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FPA Network participates in Medicaid ACO in 2017

January 2017

Stock_allergy_asthma_LrgVert_105FPA Network began participating as a Medicaid Accountable Care Organization (ACO) beginning in January. In-scope patients for care coordination to expand.

The Minnesota Department of Human Services (DHS) introduced the Integrated Health Partnerships (IHP) demonstration project in 2013 for Medical Assistance (Medicaid) recipients. Similar to the federal Pioneer demonstration project for Medicare patients, IHP is intended to deliver higher quality and lower cost health care through innovative approaches to care for those on Medicaid.

“The new ACO arrangement will bring the IHP Medicaid population in-scope for our care coordination services,” says Karen Mulder, RN, FPA director of network clinical services. Until now, FPA has focused care coordination services at independent member clinics on those patients covered under a shared savings health plan contract.

“We will be looking for new and innovative ways to serve this population,” Mulder says.

DHS measures participating systems’ success in caring for Medical Assistance members against targets for cost and quality. Systems earn payments based on risk-adjusted total cost of care (TCOC) performance, as well as on both clinical and patient experience measures.

In the first year of participation, delivery systems can share in savings when they manage total cost at below targets. After the first year, participating systems can share in savings, but also risk paying a penalty if costs of care exceed target levels.

FPA anticipates participation of approximately 53,000 Medicaid members in the program in 2017.

For more about IHP, visit www.DHS.state.mn. For more about FPA Network participation, contact Mike Schlichting, FPA Network contract administrator and finance manager, mschlic1@fairview.org, 952-914-1841.

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