Colorado Medicaid Program Continues Record Savings, Improved Outcomes

$285 million in gross savings achieved over four years

For Immediate Release

November 3, 2015

Media Contact:
Marc Williams
303-866-3144

DENVER – November 2, 2015 – The Department of Health Care Policy and Financing (Department) announced today that its Accountable Care Collaborative (ACC) program delivered more than $121 million in gross savings (costs avoided) during state fiscal year (FY) 2014-15. This is a $21 million increase in gross savings over last year.  After accounting for administrative costs which include incentive payments to providers and regional care collaborative organizations for meeting performance goals, the program’s net savings was more than $37 million.

Since FY 2011-12, the ACC has accounted for $285 million in gross savings and a net savings of $77 million.

“Colorado has been on a transformative journey since the ACC was created. In our fourth year of operationalizing the ACC, we continue to see tremendous support and great financial success,” said Susan E. Birch, MBA, BSN, RN, executive director. “What’s more, we are seeing higher quality outcomes for our members and greater satisfaction among our providers.”

Since its inception, the ACC has had four primary goals:

  • Ensure access to a focal point of care or medical home for all members
  • Coordinate medical and non-medical care and services
  • Improve member and provider experiences in the Colorado Medicaid system, and
  • Provide the necessary data to support these goals, analyze progress, and move the program forward

New this year were additional payments for primary care medical providers who met enhanced care factors to improve access and quality of care. Some of the results include: 

  • 51 percent offered after hours and/or weekend appointments
  • 54 percent offered on site behavioral health services
  • 68 percent are taking new Medicaid members

“Colorado Medicaid continues to lead the way on improving the health of our members and supporting health care providers with new tools and resources to serve their patients,” said Medicaid Director Gretchen Hammer. “The Accountable Care Collaborative model is getting people the right care, at the right time, in the right setting, and delivering high value.”

One of the ACC’s objectives is helping members be more involved in their care. The data suggest that as members spend more time in the ACC, they are more likely to receive recommended health services:

  • Prenatal Care: Healthy pregnancies promote healthy births and adequate prenatal care improves the chances of a healthy pregnancy. Women in the ACC for 7-10 months were 21 percent more likely to receive prenatal care than those enrolled six months or less.
  • Postpartum Care: Postpartum exams are important for checking the physical and mental health of new mothers as well as making referrals for chronic conditions such as diabetes, hypertension or obesity. Postpartum care increased by 10 percent for women enrolled in the ACC 7-10 months compared to women enrolled six months or less.
  • Well-Child Visits: The rate of annual well-child visits is more than double for children in the program for 7-10 months, as compared to those enrolled for six months or less.
  • Emergency Room Utilization: In addition to the points above, people who spent more time in the ACC program, were less likely to utilize higher-cost services and the ER. The rate of ER visits that did not result in an admission was about 5 percent lower for members enrolled 7-10 months than it was for those members enrolled less than six months.

For a complete report on the Accountable Care Collaborative’s performance in FY 2014-15, please visit the Department’s website.

About the Accountable Care Collaborative: The Accountable Care Collaborative (ACC) is Colorado Medicaid’s program to improve members' health and reduce costs. Nearly 900,000 members were enrolled in the ACC at the end of FY 2014-15.  Medicaid members in the ACC receive the regular Medicaid benefit package and belong to a Regional Care Collaborative Organization (RCCO). The ACC program has seven geographical regions, each served by a specific RCCO. These regional organizations provide care coordination, connect members to primary care (a medical home), specialists and community resources as needed.

The ACC is a central part of Medicaid reform that changes the incentives and health care delivery processes for providers from one that rewards a high volume of services to one that holds them accountable for health outcomes.

About the Colorado Department of Health Care Policy and Financing: The Department administers the Medicaid and Child Health Plan Plus programs as well as a variety of other programs for low-income Coloradans who qualify. For more information about the department, please visit Colorado.gov/hcpf.

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