Utah Medicaid ACO Program: A 10-Year Review

In 2013, after years under managed care and a series of non-risk contracts, Utah became one of the first states in the nation to adopt an accountable care organization (ACO) model for its Medicaid program. Rather than cutting services or raising taxes when cost growth in the state’s Medicaid program became unsustainable, state leaders designed a market-based ACO program. This strategy allowed health plans to implement innovative care delivery and management strategies within the parameters determined by the state government. The ACO program successfully reduced cost growth in Utah’s Medicaid program while maintaining a high quality of care, and it is a valuable case study for other states with similar goals.

This paper provides a background of the program, the factors that influenced the program’s design and implementation, an overview of how the program works today, and a summary of its positive impact. This work is based on a review of available evaluations and reports, as well as interviews with legislators, Medicaid directors, healthcare providers, and ACO leadership.

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