Mallika L. Mendu, MD, MBA

In Massachusetts’ largest Medicaid accountable care organization (ACO), high-risk care management significantly reduced spending, emergency department visits, and hospitalizations, demonstrating that targeted strategies can manage health care costs amid budget constraints.

Although commercial accountable care organization populations are healthy on average, some individuals might benefit from programs for high-risk patients to mitigate high levels of health care utilization.

Payment models that align financial incentives of payers, providers, and patients can mitigate spending growth in thoughtful ways, but the details of the models matter.

The authors present findings of a randomized evaluation of Medicaid patients at an academic medical center, which found that intensive care management was associated with reduced total medical expense.

The authors detail how population health management enables health systems to promote public health, strengthen health system resiliency, and support financial recovery during and beyond coronavirus disease 2019 (COVID-19).