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As part of the Department’s efforts to shift providers from volume to value, the Department, along with stakeholders, has developed a payment model to make differential fee-for-service payments based on the provider’s performance. This payment model aims to give providers greater flexibility in care provided, reward performance, and maintain transparency and accountability in payments made. Under the proposed model, providers can earn higher reimbursement when designated as meeting specific criteria or performing on quality metrics. Progress within this framework not only encourages higher organizational performance but also helps the Accountable Care Collaborative (ACC) achieve its respective programmatic goals.
The Department is adjusting the implementation of the Alternative Payment Model (APM) for participating practices.
These implementation adjustments are intended to assist practices in fully incorporating the APM into their business processes. The Department is committed to partnering with practices and ensuring all participating practices are successful in APM implementation. Practices should still select APM measures in November and December 2018 in order to properly report progress or challenge areas identified during the 2019 performance year.
Measure Selection Survey
The APM applies to providers designated as a PCMP in the ACC. To be designated as a PCMP, a provider must meet the following requirements:
The initial measure selection survey for the 2019 performance year is closed. The Department will be sending confirmation emails to the contacts provided in the survey. Beginning in May 2018 the Department will begin communications with practices about meeting the $30,000 threshold and in late summer 2018 will begin providing data back to practices on all claims-based measures. Practices will have the option to change the measures they selected for 2019 towards the end of 2018. If you have questions regarding the Primary Care APM please see the resources below or email: HCPF_primarycarepaymentreform@hcpf.state.co.us
If you are looking for information on Federally Qualified Health Centers (FQHC) please go to this page Federally Qualified Health Center Payment Reform
The time commitment would be one 60-90 minute meeting every other month. A kick-off meeting was held on November 20th from 12-1pm and the next meeting is scheduled for January 8, 2018. Meetings will be scheduled every other month thereafter. There will be a call-in option for those unable to attend in person.
If you have questions about the survey or are interested in participating in the Implementation Workgroup please send an email to our APM inbox, HCPF_PrimaryCarePaymentReform@state.co.us.
For information concerning the Primary Care Payment Reform meetings please contact:
Reasonable accommodations for the meetings will be provided upon request for persons with disabilities. Please contact HCPF_primarycarepaymentreform@hcpf.state.co.us at least one week prior to the scheduled meeting if you need special arrangements.