An Accountable Care Entity (ACE) is a new model of an integrated delivery system created under SB26, passed by the General Assembly in May 2013, and signed into law on July 22, 2013 (Public Act 98-104 (pdf). This will be the fourth model providing “care coordination services” for Medicaid clients, and will have these elements: (1) will be organized by providers and will coordinate a network of Medicaid services; (2) will initially enroll children and their family members, with an option to enroll "newly eligible" adults under ACA; (3) will each be large enough to have impact for a population: at least 40,000 clients in Cook County, 20,000 in collar counties, 10,000 downstate; (4) will include at a minimum the following types of providers: primary care, specialty care, hospitals, and behavioral healthcare; (5) will have a governance structure that includes each type of provider; (6) will build an infrastructure to support care management functions among the providers in the network, such as health information technology, risk assessment tools, data analytics, and communication with Medicaid members; and (7) will be on a 3-year path to 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.
On August 1, 2013, HFS released the solicitation requesting proposals from new entities by January 3, 2014, five months from the release of the Solicitation. The link to the Solicitation is below. Questions and comments can be directed to HFS.ACE@illinois.gov.
ACE Applicant Updates
The following nine applicants are working to become Accountable Care Entities, on or after July 1, 2014. This is contingent on addressing outstanding issues identified during the proposal evaluation, meeting the requirements of the readiness review process and negotiation of the final contract. The readiness review tool is posted below. We have listed a contact for each ACE, as we encourage collaboration and the formation of robust networks for Medicaid clients.
ACE Implementation Readiness Tools
Response to ACE Solicitation