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| Association for Community Affiliated Plans | |
|---|---|
| Name | Association for Community Affiliated Plans |
| Abbreviation | ACAP |
| Formation | 2000 |
| Type | Nonprofit trade association |
| Headquarters | United States |
| Region served | National |
Association for Community Affiliated Plans The Association for Community Affiliated Plans is a U.S.-based nonprofit trade association representing safety-net health plans, Medicaid managed care organizations, and community-affiliated health plans. It engages with federal and state agencies, health systems, and nonprofit networks to advance access to care for low-income populations, foster collaboration among Medicaid, Medicare, and dual-eligible programs, and promote value-based payment models.
Founded in 2000, the organization emerged amid policy shifts following the Clinton administration's health initiatives, interacting with actors such as the Centers for Medicare and Medicaid Services, Department of Health and Human Services, and state Medicaid agencies in places like California, New York, and Texas. Its development coincided with major legislative and regulatory events including the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, the Patient Protection and Affordable Care Act, and subsequent rulemaking by the Social Security Administration and Congress of the United States. The association expanded during the 2010s alongside Medicaid expansion decisions by states such as Ohio, Kentucky, and Michigan, and engaged with national organizations like the Kaiser Family Foundation, the Robert Wood Johnson Foundation, and the Commonwealth Fund on research and demonstrations. Leadership changes and strategic initiatives echoed broader trends reflected by entities like the National Association of Medicaid Directors, the American Public Health Association, and the Urban Institute.
Governance is structured under a board of directors drawn from member plan executives, with executive leadership accountable to oversight processes analogous to nonprofit standards exemplified by the Independent Sector and the Council on Foundations. Corporate governance practices reference compliance frameworks similar to those adopted by major health plan organizations such as Humana, Cigna, and UnitedHealth Group for audit, finance, and quality oversight. The association liaises with accreditation bodies like the National Committee for Quality Assurance and legal advisors versed in statutes including provisions administered by the Federal Trade Commission and the Department of Justice related to nonprofit operations and antitrust considerations.
Membership comprises Medicaid-focused plans, community health organizations, and local health centers across states including California, Florida, Pennsylvania, and Illinois. Partners include safety-net institutions such as community health centers, state Medicaid agencies, advocacy groups like the National Association of Community Health Centers, research institutions such as Georgetown University and Johns Hopkins University, and philanthropic entities including the Gates Foundation and Ford Foundation. Collaborations extend to national associations including the American Hospital Association, the National Association of Medicaid Directors, and specialty organizations like the Association of Community Health Plans and the National Rural Health Association.
The association provides technical assistance, quality improvement initiatives, and care management resources similar to programs developed by Centers for Medicare and Medicaid Services demonstrations, collaborating with academic partners such as Harvard T.H. Chan School of Public Health, Columbia University Mailman School of Public Health, and Yale School of Medicine. It operates learning collaboratives, data analytics support, and training modules akin to those used by Project ECHO and health information exchanges such as CommonWell Health Alliance. Services include provider network development, behavioral health integration efforts referencing models from Substance Abuse and Mental Health Services Administration and chronic disease management approaches influenced by the American Diabetes Association.
Advocacy efforts target Medicaid policy, managed care regulations, and social determinants of health initiatives, engaging legislative offices in the United States Congress, the Centers for Medicare and Medicaid Services, and state legislatures in jurisdictions such as California State Legislature and the New York State Legislature. The association files comments on proposed rules, participates in coalitions alongside groups like the National Association of Social Workers, Families USA, and the Community Catalyst, and contributes to policy discussions on topics raised by think tanks such as the Brookings Institution and the Heritage Foundation. It also engages in advocacy related to behavioral health parity laws, long-term services and supports, and demonstrations similar to the Financial Alignment Initiative.
Funding sources include member dues, grants from foundations like the Robert Wood Johnson Foundation and the Kaiser Family Foundation, contracts with state Medicaid agencies, and philanthropic support similar to awards from the John D. and Catherine T. MacArthur Foundation. Financial oversight aligns with nonprofit accounting standards promoted by the Financial Accounting Standards Board and audit practices reflective of large healthcare nonprofits such as the American Red Cross. The association publishes budget summaries and program reports comparable to disclosures by organizations like America's Health Insurance Plans and the National Association of Community Health Centers.
The association is credited with amplifying the voice of community-affiliated plans in national policy debates, contributing to quality improvement measures, and fostering innovations in care coordination similar to initiatives promoted by the Centers for Medicare and Medicaid Services Innovation Center. Critics and watchdogs including commentators from the New York Times, analysts at the Urban Institute, and policy scholars at George Washington University have raised concerns about managed care incentives, risk adjustment practices, and transparency in contracting with state Medicaid programs. Debates involve comparisons to practices at major insurers such as Aetna and Blue Cross Blue Shield affiliates, and intersect with litigation and regulatory scrutiny reminiscent of cases involving the Department of Justice and state attorneys general.
Category:Health policy organizations in the United States