ACC Updates and News
October 10, 2013: Earlier this year Colorado was chosen to participate in the National Governor’s Association’s Policy Academy for Super-Utilizers. A significant component of this year long program is exploring new ways to treat clients who use a disproportionate share of health care services. We convene a large group of stakeholders, many of which have substantial experience working with the affected clients, monthly to receive insight from a variety of sources and hopefully find a best path forward. Please click here to read the minutes from the first stakeholder meeting.
October 30, 2012: The Department of Health Care Policy and Financing's External Policy on Marketing and Outreach in the Accountable Care Collaborative Program
Now that the ACC Program is in the expansion phase, RCCOs and contracted PCMPs are permitted to develop and execute marketing plans and materials. The Department has finalized a policy for this marketing and outreach. This policy applies to all RCCOs and contracted PCMPs. To read this policy click here.
August 22, 2012: Colorado participates in Comprehensive Primary Care (CPC) Initiative
Colorado is one of seven state markets selected by the Center's for Medicare and Medicaid Services' (CMS') Innovation Center to participate in the Comprehensive Primary Care (CPC) Initiative. The CPC Initiative is focused on strengthening primary care and fostering collaboration betweeen health care systems. Colorado Medicaid is excited to be partnering with CMS and private payers on this initiative. Seventy two primary care practices in Colorado were selected to participate.
Given the alignment of the Accountable Care Collaborative (ACC) Program and the CPC Initiative's missions, the Department will implement this new primary care initiative through the existing ACC Program. The Department is asking all of the primary care practices that were selected for the CPC Initiative to enroll in the ACC Program as a Primary Care Medical Provider (PCMP). Beginning November 1, the Department will be identifying clients who have a history of seeing a CPCI provider and will take the necessary steps to enroll them in the ACC.
Please contact Kathryn Jantz at 303-866-5072 with any questions.
July 31, 2012: The Department of Health Care Policy and Financing's Position Statement on the Accountable Care Collaborative Program
After one year of operation, the Department remains committed to the Accountable Care Collaborative (ACC) Program as the predominant program that will lead Colorado Medicaid into the future of better health care. The primary goals of the ACC Program are to improve the health of our clients and reduce costs. The initial results of this program are promising; costs, utilization and client experience are trending in the right direction. We will continue to analyze program outcome and cost data on a monthly basis and will adjust the program as necessary. On November 1, 2012, we will submit a response to the legislative request for information concerning the ACC. Our response will include initial program results such as utilization and costs.
Next steps for expansion:
Beginning in August, the Department will work with the Regional Care Collaborative Organizations (RCCOs) to develop an expansion timeline and to ensure that administrative costs for the program remain budget neutral.
Beginning in October, the Department will remove the limit on the number of children enrolled in the program. The Department will prioritize the enrollment of children who can be linked to a Primary Care Medical Provider (PCMP).
Beginning in November, the Department will enroll the clients of the Comprehensive Primary Care Initiative (CPCI) practices in the ACC Program.
By Spring of 2013, the Department will begin to enroll clients dually eligible for both Medicaid and Medicare into the ACC Program.
This statement only addresses the immediate next steps for the ACC Program expansion. The Department is developing a broader vision for payment reform within the ACC Program and integration across the various delivery systems. The Department will have a robust stakeholder process as this larger vision is developed.
July 17, 2012: ACC Providers - Accountable Care Collaborative Program Referral Requirement
The Accountable Care Collaborative program will no longer require that specialists get an administrative referral from the Primary Care Medical Provider. This means that the PCMPs Provider Billing ID is not needed on a specialty claim for the claim to be paid. This policy will be officially effective after new RCCO contracts are executed.
Based on stakeholder feedback, the Department has decided that an administrative referral or a claims based referral for specialist services is not necessary. Instead, the Department will work with RCCOs to ensure that PCMPs & Specialists establish protocols for a clinical referral process. A clinical referral process would ensure there is coordination and an appropriate exchange of information between specialists and Primary Care Medical providers but would not be tied to payment.
The Statewide Data and Analytics Contractor will develop data to help RCCOs and PCMPs understand where clients are going and build processes for sharing clinical information.
If you are interested in providing input on the clinical referral process, please contact Leslie Weems at 303-866-3393 for information about our next Provider and Commnity Relations Subcommittee meeting.
May 17, 2012: ACC Providers - Incentive Payments for FY 2012-2013
In July the Department will begin the next phase of the ACC program, which includes an incentive payment structure. As of July 1, $1 of the PCMP per-member-per-month (PMPM) will be placed in an incentive pool. PCMPs will have the opportunity to earn incentive payments based on the RCCO's region-wide performance on reductions in three metrics: emergency room visits; hospital readmissions; and high cost imaging.
During the initial phase of the program (May 2011-June 2012), PCMPs authomatically received the $1 PMPM incentive payment in addition to the regular $3 PMPM. PCMPs will continue to receive this $3 PMPM during the next phase of the program, with the opportunity to earn the additional $1 PMPM as an incentive payment.
The ACC is Medicaid's new program to improve client health and contain costs. Medicaid clients enrolled in the ACC receive full Medicaid benefits and also belong to a Regional Care Collaborative Organization that provides care coordination among providers and other community and government services.
April 23, 2012: The Department of Health Care Policy and Financing will continue to pay the current pay-for-performance reimbursement to all Children's Medical Home providers (including those who are participating as Primary Care Medical Providers (PCMPs) in the Accountable Care Collaborative program) through state fiscal year 12-13 (July-June).
The Department had originally planned to discontinue Children's Medical Home pay-for-performance payments in July 2012 and transition to per-member-per-month (PMPM) payments made under the Accountable Care Collaborative program. However, since the Accountable Care Collaborative program seeks to build off the successes of the Children's Medical Home program, the Department would like to work with the Accountable Care Collaborative's Regional Care Collaborative Organizations (RCCOs) and Children's Medical Home providers to determnie the best way to integrate the two programs. In preparation of greater alignment between the two programs, the Department encourages all Children's Medical Home porviders to contact the Regional Care Collaborative Organization in their region to become a primary care medical provider in the Accountable Care Collaborative program and to participate in Advisory Committee discussions on further integration of the programs.