Alabama’s plan for a new system of risk-based healthcare organizations to serve the state’s Medicaid recipients achieved its second major milestone with the submission of 12 applications for probationary certification by the September 30 deadline. Click here to see a list of applicants.
Three applications for probationary certification as a Regional Care Organization were filed in Region A (North Alabama) and Region C (West Alabama) while two applications each were filed in Region B (Central / East Alabama), Region D (Central / Southeast Alabama) and in Region E (South /Southwest Alabama) Click here to see a map of the regions.
“There has been a remarkable level of interest in developing locally-led organizations as evidenced by the submission of these applications,” said Dr. Don Williamson, chair of the Alabama Medicaid Transition Task Force. “This confirms our belief that RCOs represent a viable vehicle for transforming Medicaid.”
The application period opened in May when the state adopted rules outlining the application process and other requirements. RCOs potentially could have been certified by October 1, 2014, although state law allows for additional time if there is evidence of substantive progress and a decision on probationary certification can be made before January 1, 2015.
Between now and the end of the year, the organizations must finalize their applications and obtain official approval from Alabama Medicaid. Once they receive probationary certification, the applicants will be required to demonstrate that they have an adequate provider network and that they can meet solvency and other financial requirements before receiving final certification.
Probationary certification also will allow applicants the option to manage a Health Home program in advance of full-risk requirements. Medicaid’s Health Home program currently operates in four regions of the state to help Medicaid recipients with complex or multiple medical conditions improve their health outcomes while reducing the cost of care to the state. Probationary RCOs will be eligible to respond to a Health Home Request for Proposals scheduled for release in January 2015.