Online Program

Role of state law in linking public health, primary care, and accountable care

Wednesday, November 6, 2013 : 11:15 a.m. - 11:30 a.m.

Tara Ramanathan, JD, MPH, Public Health Law Program, Office for State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA
Rosa Klein, MPP, Health Share of Oregon, Portland, OR
Jennifer DeCubellis, LPC, Hennepin County Human Services & Public Health Dept, Minneapolis, MN
The linkage of public health, primary care, and accountable care has emerged as a new opportunity in US health care. For example, new state laws apply accountable and coordinated care principles to Medicaid programs to serve the public health needs of vulnerable populations. Under state laws, accountable care organizations receiving Medicaid reimbursement may be responsible for providing a variety of public health services, including preventive physical and mental health-care services and related behavioral, long-term care, substance abuse, and dental services. Local health departments across the country are collaborating with private providers through innovative accountable and coordinated care models or pilots in accordance with these laws.

This session will begin with an introduction to accountable care organizations and their scope, functions, and structures. The presentation will include a comparative analysis of state laws on Medicaid accountable and coordinated care, covering provisions related to legal authority, coverage, delivery system, data management, financing, compliance and accountability, and enforcement. The presenter will provide case studies of two local jurisdictions that have taken part in Medicaid accountable care and introduce data that describe the strengths and weaknesses of their programs based on the legal provisions that created them. The session will conclude with a discussion of the impact state laws can have in 1) linking public health and primary care and 2) requiring consideration of health outcomes in reimbursement mechanisms.

Learning Areas:

Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Describe the role of state law in supporting accountable care organizations (ACOs). Identify the scope, functions, and structure of ACOs. Compare the state laws authorizing the creation and implementation of ACOs in two US jurisdictions. Discuss the role of public health in the ACOs created at the local level. Assess the strengths and weaknesses of two local ACOs.

Keyword(s): Law, Health Care Reform

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the primary analyst on state laws related to accountable care at the Public Health Law Program at CDC for the last two years and have worked with federal, state, and local government officials to inform the research on this topic.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.