Federal and state health reform efforts present compelling opportunities to advance new payment and delivery system models to improve the quality of healthcare services and rein in costs. An emerging challenge for policymakers is to create alignment among these initiatives so that proliferation of payment and delivery system models does not lead to conflicting financial incentives and burdensome reporting requirements for providers.

In a report, "High-Performance Health Care for Vulnerable Populations: A Policy Framework for Promoting Accountable Care in Medicaid," prepared for The Commonwealth Fund, Deborah Bachrach, William Bernstein and Anne Karl of Manatt note that Medicaid can play a significant role in harmonizing the various delivery system reform initiatives and in driving change that fosters greater accountability and improved performance across the health system and across payers. The report focuses on the Medicare Shared Savings Program (MSSP) as an example of how Medicaid might build on reform programs in Medicare and lays out a proposed framework for states to create accountable care organizations (ACOs) to care for their Medicaid populations.