Accountable Care Collaborative Phase II—Member Messaging Resource Center

On July 1, 2018, the next iteration of the Accountable Care Collaborative (ACC) launched. The ACC seeks to leverage the proven successes of Colorado Medicaid’s programs to enhance the Health First Colorado (Colorado’s Medicaid program) member and provider experience. For more information and resources for providers and stakeholders on the next iteration of the ACC, go to CO.gov/HCPF/ACCPhase2.

To support the July 1 launch, 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.

Click on the resource below.

Member Terminology

Member communications should be consistent and written in plain language. The Department is working toward incorporating plain language into all member correspondence and communications sent to members by its contractors and partners. The Department has compiled the below style chart to advise member communications. Member communications should always follow the guidance in this style chart.

USE THIS NOT THIS

Qualify

Eligible/Eligibility

Primary care provider (PCP)

Primary care medical provider (PCMP)

Regional organization (lower case; never an acronym)

Regional Accountable Entity (RAE); health plan

Health First Colorado Enrollment

Health First Colorado Enrollment Broker; Health Colorado

Health First Colorado

Medicaid; Accountable Care Collaborative

Member

Client; beneficiary; enrollee

Managed care plan

Managed Care Organization

Standard Member Message

The Department has developed the below standard message to describe to members what the ACC program is. We encourage partners to use when communicating with members.

Short Message

As a member of Health First Colorado (Colorado’s Medicaid Program), you have a primary care provider. Your primary care provider is your first contact for your health and wellness services. Health First Colorado will assign you to a primary care provider. You can choose a different participating primary care provider at any time by calling Health First Colorado Enrollment. You and your provider belong to a regional organization that helps you make sure you get the health care and services you need. Your regional organization can also help you understand and manage your physical and behavioral health benefits, help connect you to providers, and connect you with resources for needs such as transportation, food assistance or other social services. 

Long Message

Every member of Health First Colorado (Colorado’s Medicaid Program) has a primary care provider and belongs to a regional organization that helps connect you with the health care you need.

Your primary care provider is your first contact for your health and wellness services. They work with you to keep you healthy and help you manage your health conditions. Your primary care provider keeps track of your health history and health care needs and shares this information with your other providers as needed. Get to know your primary care provider and help them get to know you, so you can make health care decisions with someone you trust. Health First Colorado will assign you with a primary care provider. You can choose another participating primary care provider at any time by calling Health First Colorado Enrollment.

You belong to the regional organization your primary care provider works with. Your regional organization can help you understand and use your health care benefits and help you find providers for your physical and behavioral health needs.

If you have complicated health needs or are having trouble getting the health care you need, your regional organization can help you get care coordination. Care coordination offers different supports to make sure you have the resources you need to take care of your health. Depending on your needs, care coordination may include helping you get transportation to your medical appointments, finding a specialist, or helping you find programs for things like food assistance.

Health First Colorado Enrollment will send you a letter that says who your primary care provider and regional organization are. If you want to change your primary care provider, contact Health First Colorado Enrollment at 303-839-2120, 1-888-367-6557 (outside of Denver), Monday-Friday, 8:00 a.m. to 5:00 p.m.; State Relay: 711 for callers with hearing or speech disabilities.

Sample Talking Points

The Department has developed the below sample talking points for partners to use when communicating with members.

Regional Organizations

  • Starting July 1, 2018, Health First Colorado is contracting with one organization in each region of the state to manage both your physical and behavioral health care. This organization is called your regional organization 
  • You and your Primary Care Provider (PCP) belong to a regional organization that helps you make sure you get the health care and services you need
    • Your regional organization can help you understand and manage your physical and behavioral health benefits, help connect you to providers, and connect you with resources for needs such as transportation, food assistance or other social services
    • You belong to the regional organization your primary care provider works with
    • Your regional organization can help you understand and use your health care benefits and help you find providers for your physical and behavioral health needs

Primary Care Provider

  • Every Health First Colorado member has a primary care provider, or PCP
    • Your PCP works with you to keep you healthy and help you manage your health conditions
    • Your PCP keeps track of your health history and health care needs and shares this information with your other providers as needed
    • Get to know your PCP and help them get to know you, so you can make health care decisions with someone you trust
  • You can choose a different PCP at any time

Care Coordination

  • If you have complicated health needs or are having trouble getting the health care you need, your regional organization can help you get care coordination
  • Care coordination offers different supports to make sure you have the resources you need to take care of your health
  • Depending on your needs, care coordination may include helping you get transportation to your medical appointments, finding a specialist, or helping you find programs for things like food assistance

Member Frequently Asked Questions

The Department has developed frequently asked questions to help partners answer questions from members.

Sample Hold Messaging

The Department has developed the below sample hold message for partners to use on their hold messaging or voicemails.

Attention Health First Colorado members! Starting July 1, you will have one regional organization to manage both your physical and behavioral health care. Your eligibility and benefits are not changing.

Have you recently moved? Keep your information up to date the easy way with PEAK. No more waiting in line or waiting on hold. Change your address at CO.gov/PEAK. In PEAK, you can also choose to have your letters sent through email. For PEAK on-the-go, download our free PEAKHealth app from any app store.

Did you know?

  • Every Health First Colorado member has a primary care provider, or PCP
  • Your PCP works with you to keep you healthy and help you manage your physical and behavioral health
  • Get to know your PCP and help them get to know you, so you can make health care decisions with someone you trust
  • You can change your PCP at any time

Health First Colorado members-- Help us get to know you!  Answer a few questions at healthfirstcolorado.com/health-survey   

Newsletter article about the resource center to include in publications

Health First Colorado launches the Accountable Care Collaborative Phase II: Information for Our Partners from the Department of Health Care Policy & Financing

The next iteration of the Accountable Care Collaborative began July 1, 2018. The goals are to improve Health First Colorado member health and reduce costs.

Member Communications
A Member Messaging Resource Center for our partners is available on CO.gov/HCPF/ACCPhase2. This resource center will provide you the latest information and messaging for Health First Colorado members. We will regularly add to the resource center, so check back often.

Resources available now include:

  • Regional Collaborative Care Organization and Behavioral health Organization Transition Letters 
  • Managed Care Plan Initial Enrollment and Attribution Letter
  • Primary Care Provider and Regional Organization Initial Enrollment and Attribution Letter

Submitting Questions
At this time, we ask that members, providers and other interested parties start by contacting their regional organization if they have questions. In addition, interested parties can submit their questions to the Department using this form.  The Department will not be able to respond directly to all inquiries but will direct questions to the appropriate entity while we work closely with the regional organizations and other contractors to address critical issues. The Department will continue to use the questions submitted to tailor upcoming communications and resources. We ask for everyone’s cooperation as we work to identify and resolve critical issues.   

Member Contact List—Who to go to for what

The Department has developed the below list of common contacts members may need. Please use this list when directing members.

Who For What How

Health First Colorado Enrollment

  • Changing your primary care provider
  • Requesting a handbook
  • Getting help finding a provider

303-839-2120
1-888-367-6557 (outside of Denver) Monday-Friday, 8:00 a.m. to 5:00 p.m.
State Relay: 711 for callers with hearing or speech disabilities

 

County Department of Human/Social Services

  • Applying for benefits Questions about what programs you qualify for
  • Reporting changes to your household

Contact information for each County Office

Primary Care Provider

  • Making an appointment
  • Getting help finding other providers
  • Getting assistance coordinating your care

The name of your primary care provider is listed on your enrollment letter or you can contact Health First Colorado Enrollment:
303-839-2120
1-888-367-6557 (outside of Denver)
Monday-Friday, 8:00 a.m. to 5:00 p.m.

State Relay: 711 for callers with hearing or speech disabilities

Regional Organization

  • Getting assistance coordinating your care
  • Getting help finding a provider
  • Getting connected to behavioral health (mental health or substance use disorder) services
  • Filing a grievance

Colorado Access
303-368-0037 or 1-855-267-2095 (toll free)
303-368-0038 (Denver County) or 1-855-384-7926 (toll free) (Denver County)
Monday-Friday, 8:00 a.m. to 5:00 p.m.
State Relay: 711 for callers with hearing or speech disabilities

http://www.coaccess.com/

Colorado Community Health Alliance
303-256-1717, 719-598-1540, or
1-855-627-4685 (toll free)
Monday-Friday, 8:00 a.m. to 5:00 p.m.
State Relay: 711 for callers with hearing or speech disabilities

http://www.cchacares.com/

Health Colorado, Inc.
1-888-502-4185
Care Coordination Line: 1-888-502-4186 Monday-Friday, 8:00 a.m. to 5:00 p.m.
State Relay: 711 for callers with hearing or speech disabilities

https://www.healthcoloradorae.com/

Northeast Health Partners
1-888-502-4189
Care Coordination Line: 1-888-502-4190
Monday-Friday, 8:00 a.m. to 5:00 p.m.
State Relay: 711 for callers with hearing or speech disabilities
https://www.northeasthealthpartners.org/

Rocky Mountain Health Plans
1-888-282-8801
Monday-Friday, 8:00 a.m. to 5:00 p.m.
State Relay: 711 for callers with hearing or speech disabilities

Email: customer_service@rmhp.org
Live chat at: https://www.rmhp.org/

Health First Colorado Member Contact Center

  • Getting help finding a provider
  • Getting help if you received a bill from a provider
  • Requesting a new Health First Colorado card

1-800-221-3943
Monday – Friday 7:30 a.m. to 5:15 p.m.
State Relay: 711 for callers with hearing or speech disabilities

 

The Ombudsman for Medicaid Managed Care

  • Help with a grievance, appeal or other issue related to your health care

303-830-3560 or 1-877-435-7123
For TDD/TTY, call 888-876-8864
Or email help123@maximus.com

Nurse Advice Line

  • Available free of charge, 24 hours a day, 7 days a week, 365 days a year
  • Nurses will answer your medical questions, provide care advice and help you determine if you should be see a doctor right away
  • Get help with medical conditions, such as diabetes or asthma
  • Get advice on the type of doctor that may be right for your medical condition

1-800-283-3221
TTY 303-389-1210
24 hours a day, every day of the year

Behavioral Health Organization (BHO) & Regional Collaborative Care Organization (RCCO) Transition Letters

Transition Letter Basics

  • One-time informational letter; member action is not required
  • Tells members that their physical and behavioral health benefits will be managed by one organization and that they will get a letter with more information
  • Sent at the individual level to members in active care coordination/case management with the RCCO or BHO
  • Designed with member feedback and using plain language principles
  • Available in English and Spanish
  • RCCO or BHO is listed on letter as who to contact with questions and return address
  • Features RCCO or BHO logo
BHO Transition Letter Specifics RCCO Transition Letter Specifics

Sent to members mid to late May

Sent to members mid to late May

Includes BHO name and phone number

Includes RCCO name and phone number

Sample letter—English

Sample letter—English

Health First Colorado Enrollment Letters

Initial Member Attribution and Enrollment Letter Basics

  • One-time informational letter; member action is not required
  • Sent at the household level to the head of household
  • Includes all members of the household who qualify for Health First Colorado*
  • Designed with member feedback and uses plain language principles
  • Available in English and Spanish
  • Health First Colorado Enrollment is listed on letter as who to contact with questions and the letter includes its return address
  • Features Health First Colorado logo
  • Includes link to optional member health needs survey

* Households with some members in a managed care plan and other members assigned to a primary care provider and regional organization will receive separate letters

Managed Care Plan/Regional Organization Letter Specifics

Primary Care Provider/Regional Organization Letter Specifics

Sent to members on June 27

Sent to members in phases between July 2-23

Tells members their assigned managed care plan name and phone number, and regional organization and phone number

Tells members their primary care provider name and phone number and regional organization and phone number

Sent to members enrolled in Denver Health Medicaid Choice or Rocky PRIME and a regional organization

Sent to members enrolled in a regional organization

Sample of Managed Care Plan/Regional Organization Letter—English and Spanish

Sample of Primary Care Provider/Regional Organization Letter—English and Spanish

Ongoing Member Attribution and Enrollment Letter Basics

  • Member action is not required
  • Sent at the household level to the head of household
  • Includes all members of the household who qualify for Health First Colorado*
  • Designed with member feedback and uses plain language principles
  • Available in English and Spanish
  • Health First Colorado Enrollment is listed on letter as who to contact with questions and the letter includes its return address
  • Features Health First Colorado logo
  • Includes link to optional member health needs survey

* Households with some members in a managed care plan and other members assigned to a primary care provider and regional organization will receive separate letters

Managed Care Plan/Regional Organization Letter Specifics

Primary Care Provider/Regional Organization Letter Specifics

Sent to newly enrolled members

Sent to newly enrolled members

Tells members their assigned managed care plan name and phone number, and regional organization and phone number

Tells members their primary care provider name and phone number and regional organization and phone number

Sent to members enrolled in Denver Health Medicaid Choice or Rocky PRIME and a regional organization

Sent to members enrolled in a regional organization

Sample of Ongoing Managed Care Plan/Regional Organization Letter—English and Spanish

Sample of Ongoing Primary Care Provider/Regional Organization Letter—English and Spanish

Health Needs Survey Frequently Asked Questions for Members

Question Answer

Why are you collecting this information?

The information you provide will help your regional organization get you and other Health First Colorado members in your household the health care and services you need. We are also collecting this information to help us better identify Health First Colorado members who have unmet health needs and could benefit from additional support.

Will you share my information? If so, who will see it?

Your responses will be shared with your regional organization. It will help them get you and other Health First Colorado members in your household the health care and services you need.  The regional organization may share this information with your primary care provider.

Will answering this survey change my eligibility or my benefits?

No, your eligibility or your benefits will not change.

Will somebody be calling me? If so, when will they be following up?

Someone may contact you to see how they may help. If you or a Health First Colorado household members has immediate needs, contact your primary care provider.

Will anyone in my family see the responses?

No, your responses will not be shared with anyone in your household. Your responses will be shared with your regional organization.

Do I have to fill out this survey for each member of my household?

Yes, we recommend you fill it out for each Health First Colorado household member, especially if they have complex health care needs. The information you provide will help your regional organization get you and other Health First Colorado members in your household the health care and services you need.

Am I required to take this survey?

No, this survey is not required, but it will help your regional organization get to know you better.

What is a regional organization?

Your Health First Colorado regional organization manages both your physical and behavioral health care. They support a network of providers to make sure you can access health care for your body, vision, mental health, and substance use in a coordinated way.  Every Health First Colorado member belongs to a regional organization.  Your regional organization is on your enrollment letter.