Collaborative Publishes Primary Care Payment Recommendations
Recommendations are to help increase investment in primary care.
DENVER (Dec. 16, 2019) – The Colorado Primary Care Payment Reform Collaborative (the Collaborative) has published its first Primary Care Payment Reform Recommendations Report, which offers guidance on how Colorado can improve and advance primary care delivery to ensure all Coloradans can get the right care, at the right time, in the right place.
The Collaborative, created through HB19-1233 and convened by the Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), has been meeting since July of this year to develop a set of recommendations aimed at increasing investments in high-quality primary care. Increased investment can lead to better access, and access to primary care is a key part of our health care system.
“We know that primary care is a critical component of health care in Colorado,” said Insurance Commissioner Michael Conway. “The Collaborative’s effort has resulted in a report that provides a framework for the Division’s work in advancing primary care moving forward.”
There are five key recommendations from this first report.
- An inclusive definition of primary care, which includes a broad range of provider types, including family medicine physicians, general pediatric and adolescent medicine physicians and geriatric medicine.
- A recommended primary care investment target - After discussion and review of currently available data, the Collaborative is recommending a one percentage point increase in primary care spending by commercial insurance companies in 2021 and again in 2022. The Collaborative will work with the Center for Innovation in Health Care (CIVHC) in 2020 to improve the data currently available on primary care spending, and establish a reliable baseline for each payer. After one percentage point increases in 2021 and 2022, the Collaborative intends to re-evaluate this target in 2022, to make sure it is leading to better outcomes and more affordable care for all Coloradans.
- A recommendation to identify and track short, medium, and long-term measures that are expected to be improved through increased investment in primary care.
- A recommendation that increased investments should support primary care providers in adopting evidence-based, advance care delivery models that focus on whole person care, which is the coordination of health, behavioral health and social services for care that focuses on the patient’s needs.
- A recommendation that increased investments in primary care should be offered primarily through infrastructure investments and alternative payment models, which focus on quality of care and health outcomes rather than the volume of patients treated.
The Collaborative is tasked with delivering a report annually, every Dec. 15, to the Insurance Commissioner with recommendations concerning increased investment in primary care. The group used the Colorado Health Institute to compile this year’s report. The Collaborative consists of 22 people from all over the state in all areas of health care - primary care physicians, consumers, health insurers, government entities and actuaries.
The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA) regulates the insurance industry and assists consumers and other stakeholders with insurance issues. Visit dora.colorado.gov/insurance for more information or call 303-894-7499 / toll free 800-930-3745.
The National Association of Insurance Commissioners (NAIC) is the U.S. standard-setting and regulatory support organization created and governed by the chief insurance regulators from the 50 states, the District of Columbia and five U.S. territories. Through the NAIC, state insurance regulators establish standards and best practices, conduct peer review, and coordinate their regulatory oversight. For more information, visit naic.org.
DORA is dedicated to preserving the integrity of the marketplace and is committed to promoting a fair and competitive business environment in Colorado. Consumer protection is our mission. Visit dora.colorado.gov for more information or call 303-894-7855 / toll free 1-800-886-7675.