Alabama Regional Care Organizations (RCOs)

Program Location: 
Montgomery, AL
Payer Type: 

Alabama Regional Care Organizations are scheduled to be implemented in October 2016. Regional Care Organizations (RCOs) are locally-led managed care systems that will ultimately provide healthcare services to most Medicaid enrollees at an established cost under the supervision and approval of the Alabama Medicaid Agency. State legislation passed in 2013 and updated in 2014 created the new managed care structure to enable Medicaid to move away from a volume-based, fee-for-service environment to a payment system that incentivizes the delivery of quality health care and improved health outcomes. 

Some of the services to be covered by RCOs include hospital inpatient and outpatient care, emergency room services, primary and specialty care, services provided by a federally-qualified health center or rural health clinic, lab and radiology services, mental/behavioral health, eye care and maternity care. Long term care, dental care and pharmacy services are excluded now. 

Related News & Resources

Payment Model: 

Capitated payment to RCOs, which determine how to apportion that payment amongst providers in both FFS and at-risk contracts.

- Leavitt Partners, September 2015

Last updated September 2015
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