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

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.