Accountable Care Collaborative Phase II

The Department has published and will regularly update information on this Provider & Stakeholder Resource Center. This resource center includes fact sheets, FAQs webinars and other resources for providers and stakeholders about Phase II.

The Department has developed and will regularly update this Member Messaging Resource Center. This resource center includes messaging for Health First Colorado members that can be used by our partners including sample letters, talking points, frequently asked questions, and more—all developed with our Health First Colorado members in mind. We ask our partners to use these resources when communicating with Health First Colorado members about the next iteration of the ACC.

The Department recently submitted to the Centers for Medicare and Medicaid Services (CMS) the Section 1915(b) Waiver Proposal for ACC Phase II. This waiver provides the federal authority to establish the ACC as a mandatory program and to create single regional managed care entities responsible for promoting physical and behavioral health for members. This waiver replaces the previous Behavioral Health Organization (BHO) waiver. CMS approved the waiver on May 21, 2018. 

Section 1915(b) Waiver 

The Department shares regular updates via email on the ACC Phase II. Sign up for our updates. 

• ACC Phase II September 28, 2018 Update
• ACC Phase II August 2, 2018 Update
• ACC Phase II July 18, 2018 Update
• Accountable Care Collaborative Phase II Information for Case Managers July 17, 2018
• Accountable Care Collaborative Phase II Information for HCBS Providers July 17, 2018
• Important Information for Medicaid Primary Care Medical Providers July 5, 2018
• Accountable Care Collaborative Phase II Launches July 1: What Providers Need to Know July 29, 2018
• Providing Behavioral Health Services During the Transition to Regional Accountable Entities July 29, 2018
• ACC Phase II June 29, 2018 Update
• ACC Phase II June 25, 2018 Update
• ACC Phase II June 6, 2018 Update
• ACC Phase II May 18, 2018 Update
• ACC Phase II May 2, 2018 Update
• Contracting Guidance for Health First Colorado Mental Health and Substance Use Disorder Providers April 20, 2018
• ACC Phase II April 11, 2018 Update
• ACC Phase II March 16, 2018 Update
• ACC Phase II March 2, 2018 Update
• ACC Phase II February 14, 2018 Update
• ACC Phase II January 17, 2018 Update
• ACC Phase II November 27, 2017 Update
• ACC Phase II November 2, 2017 Update
• ACC Phase II May 11, 2017 Update
• ACC Phase II February 2017 Update
• ACC Phase II January 11, 2017 Update
• ACC Phase II January 3, 2017 Update
• ACC Phase II December 23, 2016 Update
• ACC Phase II December 12, 2016 Update
• ACC Phase II December 5, 2016 Update
• ACC Phase II November 28, 2016 Update
• ACC Phase II November 18, 2016 Update
• ACC Phase II November 2016 Update
• ACC Phase II Draft RFP Available Online
• ACC Phase II October 2016 Update
• ACC Phase II August 2016 Update
• ACC Phase II July 2016 Update
• ACC Phase II May 2016 Update
• ACC Phase II April 2016 Update
• ACC Phase II March 2016 Update
• ACC Phase II February 2016 Update
• ACC Phase II January 2016 Update
• ACC Phase II December 2015 Update
• ACC Phase II November 2015 Update

Regional Accountable Entity for the Accountable Care Collaborative RFP Body
Appendix A Administrative Information
Appendix AA Denver Health Medicaid Choice Contract
Appendix B  Draft Personal Services Contract
Appendix BB Draft Behavioral Health Capitation Rates
Appendix C W-9
Appendix CC Health Maintenance Organization Rate Development
Appendix D Map of Regions
Appendix DD Rocky Mountain PRIME Capitation Rate Development
Appendix E Assignment Estimates
Appendix EE Provider Type Codes
Appendix F Enrollment and Attribution
Appendix FF Behavioral Health Penetration Rates
Appendix G Health Needs Survey Questions
Appendix GG Behavioral Health Organization Network of Providers
Appendix H Primary Care - Specialist Physician Collaborative
Appendix HH Data Sets
Appendix I Population Health Management Plan
Appendix II Deliverable List
Appendix J Stratification Report
Appendix JJ HIPAA BAA
Appendix K Practice Support Tools and Resources
Appendix KK Regional Accountable Entity for the Accountable Care Collaborative – Data Access Request
Appendix L Colorado Client Assessment Record
Appendix LL Data Use Agreement
Appendix M Primary Care Alternative Payment Methodology
Appendix MM Ownership Controlling Interest & Conviction Disclosure Completion Instructions
Appendix N Development Disability and Traumatic Brain Injury Guidance
Appendix O Capitated Behavioral Health Benefit Covered Services
Appendix P Short-term Behavioral Health Services in a Primary Care Setting
Appendix Q Peer Specialist Core Competencies
Appendix R 1915(b)(3) Services Report
Appendix S Non-State Plan 1915(b)(3) Waiver Services Plan
Appendix T Medical Loss Ratio Calculation Template
Appendix U Performance Measures
Appendix V Community Behavioral Health Services Program Performance Incentive Program
Appendix W Disproportionate Share & Graduate Medical Education Hospital Reporting
Appendix X Memorandum of Understanding between CMS and the State of Colorado
Appendix Y Final Demonstration Agreement
Appendix Z Rocky Mountain Health Maintenance Organization Amendment 5

Draft Request for Proposals and Stakeholder Comments

The Department would like to thank the more than 255 providers, advocates, potential vendors and other stakeholders who provided comments on the draft Accountable Care Collaborative Phase II draft request for proposals (RFP) and corresponding appendices. The Department sought targeted comments on the draft RFP from stakeholders to help refine the content for the formal release of the RFP in the spring 2017.

Since April 2014, the Department has been in ongoing conversations with stakeholders across the state regarding the next iteration of the Accountable Care Collaborative. The Department sought targeted comments between November 4, 2016 and January 13, 2017 on the draft RFP from stakeholders to help refine the content for the formal release of the RFP in the spring 2017. The snapshot below shows the Department’s outreach efforts on the draft RFP. 

The Department has worked diligently to distill, and where possible, incorporate comments received on the draft RFP.

Respondents expressed in their comments overall support for increasing integration of the behavioral and physical health systems, increased focus on member responsiveness, and increased steps to build the health neighborhood.

The Department was able to make some updates to the RFP and encourages stakeholders to review the final scope of work in the RFP for additional details. Some reoccurring comments, however, were unable to be incorporated in to the RFP by the Department including:

• Requests for expanding Health First Colorado benefits
• Requests for alterations to federal managed care regulation language and requirements, including number of deliverables
• Requests for prescriptive requirements impacting specific target populations
• Recommendations that are more appropriate for implementation rather than contracting

Key Concepts and Fact Sheets

 Accountable Care Collaborative Phase II Key Concepts

• In mid-October 2015, the Department published the ACC Phase II Concept Paper. The Concept Paper provided a venue to share some of the Department’s proposed plans for reforming Medicaid and initiate conversations with federal, state, and local partners. From the onset, the Department planned to adjust some proposed policies based on further research and stakeholder feedback. Current policy and program decisions can be found below under the heading ACC Model Details, Policy & Program Decisions, Whitepapers & Fact Sheets. 
• ACC Phase II Overview Presentation (updated April 2016)

Fact Sheets & Policy Decisions

• Framework for Behavioral Health Reimbursement: This document outlines the Department’s framework for behavioral health reimbursement under Phase II.      
• Behavioral Health Reimbursement Program Decision: This documents updates the stakeholder on a change to the Department’s proposal for reimbursing behavioral health services.
• ACC Phase II Program Decision Reimbursement for Behavioral Health Services Presentation: Recorded presentation that provides an overview of ACC Phase II, behavioral health key concepts, the procurement timeline and how to stay informed.
• April 2015 ACC Model Details & Policy Decisions: This document explains three key structural decisions that have been made for the ACC Model in the future: RCCO-BHO Administrative Structure, Regional Maps, and Payment.
• Q&A from the ACC Model Details and Policy Decisions Document: This document responds to the questions we've received related to the April 2015 Model Details & Policy Decisions document.

• ACC Phase II Overview of Key Concepts (updated February 2016): This fact sheet provides a brief overview of the Phase II key concepts. For additional information please refer to the Concept Paper.
• ACC Phase II Overview of Stakeholder Engagement: This fact sheet provides a brief overview of the various phases of stakeholder engagement related to the ACC Phase II.
• ACC Program Improvement Advisory Committee (PIAC) Structure: This fact sheet provides an overview of the PIAC structure. This committee and subcommittees have been an integral part of the development of ACC Phase II.
• ACC Budget and Legislative Authority Timeline: This fact sheet provides a brief timeline of the budget and legislative action related to the ACC.
• ​ACC Phase I Request for Proposals (RFP) from 2010: This is the full text of the RCCO RFP (ACC I Request for Proposals) released in 2010.  It contains the foundation on which the ACC Program is based.

2014 Request for Information

The release of the ACC Request for Information (RFI) is one of the first steps to determine what the ACC will look like in the future.

RFIs are used to solicit advice and expertise from the public in advance of the creation of an RFP or a contract. Anyone is welcome to respond to an RFI, though oftentimes certain sections of an RFI are tailored to specific groups or entities – like providers, clients, or potential vendors. Alongside Colorado Health Institute (CHI), the Department has attended numerous public meetings across the state to hear stakeholders' concerns and aspirations.  These conversations have helped to inform the RFI process.

The RCCO RFI was a "question-only" request for information. This means the RFI contained a series of targeted questions, rather than extensive draft contract language. This process has two advantages. First, it allows respondents greater latitude to focus on the areas they think are most important. Second, the information and perspectives shared by respondents are able to frame the conversation before specific contract requirements are formulated.

The RFI was released in late October 2014 and formal responses were due on November 24, 2014.

The RFI questions are available on Colorado BIDS and below.

• Executive Summary of ACC RFI
• Text of Responses to ACC RFI
• Download the ACC Request for Information
• Download a printable version of the ACC Request for Information