Assessing the extent and efficacy of existing care coordination efforts will enable states to identify gaps and overlaps, thus enabling them to make informed decisions to reallocate resources, enhance existing efforts or launch new efforts.

*Milestone details:

*Full name: Assess the degree to which programs that provide care coordination functions exist in the state and develop new or support existing efforts to expand care coordination.

*Relevance to the ACA:

Enhancing care coordination – especially for vulnerable populations – is an aim of many ACA programs and initiatives. Some of the most relevant ACA opportunities to promote care coordination include:

§1311 – Health plans participating in health insurance exchanges will be required to report on quality improvement strategies such as care coordination.

§2602 – Federal Coordinated Health Care Office to support state efforts to improve coordination of care for duals.

§3021, §10306 – Mandate of new CMS Center for Medicare and Medicaid Innovation includes promoting care coordination.

A variety of other sections of the ACA also offer promise for improving care coordination, but with a more limited state role. In particular, Medicare is to launch an ACO program (§3022), a payment bundling pilot (§3023), an Independence at Home Demonstration (§3024), and a Community-Based Care Transitions Program (§3026).