Alabama Medicaid Certifies 11 Probationary Regional Care Organizations In Shift To Risk-Based Care

On December 31, 2014, the Alabama Medicaid Agency (AMA) announced that 11 health care provider organizations had been certified as probationary Medicaid Regional Care Organizations (RCOs). The RCOs are part of Alabama’s Medicaid 1115 demonstration waiver to shift its Medicaid program from fee-for-service (FFS) to regional risk-based accountable care organizations. During the demonstration which is expected to begin October 1, 2016, the RCOs will receive a prospective capitation payment from AMA to cover the costs of all acute, behavioral, pharmacy, post-acute and rehabilitation services provided to RCO members, plus the RCO’s related administrative costs . . .