Accountable Care Collaborative Phase II Presented by: Emily Berry, MPH Oct-19

HCPF Mission

Moving toward more coordinated and integrated care that increasingly rewards improved health Long-Term Vision ACC designed with this mission and long-term vision Iterative to keep up with evolving health care system

Accountable Care Collaborative Improve Health and Reduce Costs Ensure Members have a focal point of care. In the ACC, this is referred to as a Primary Care Medical Provider (PCMP). Medical Home Health First Colorado Members have complex needs and are served by multiple systems. Regional umbrella organizations help to coordinate across systems. Regional Coordination Members, providers and the system receive the data needed to make real-time decisions that improve care, increase coordination of services and improve overall efficiencies. Data

To improve member health & reduce costs Goals Join physical and behavioral health under one accountable entity Strengthen coordination of services by advancing team-based care and health neighborhoods Promote member choice and engagement Pay providers for the increased value they deliver Ensure greater accountability and transparency Objectives ACC Phase II builds on Phase I.

Regional Accountable Entity Physical Health Care Behavioral Health Care 1st Objective: Join physical and behavioral health under one entity First step in integration Continue to have two different payment methods Per Member/ Per Month Behavioral Health Capitation

Regions Like the previous ACC Program, there are 7 regions in ACC Phase II, which are depicted on the map here. Limited capitated management initiatives in Region 1 (RMHP Prime) and Region 5 (Denver Health Medicaid Choice)

Total Medicaid Caseload January 2019 Data pulled February 2019

ACC Enrollment by RAE Data pulled February 2019

PCMPs by Type Data pulled February 2019 Sum: 856 Approximate percentage (rounded): 20% pediatric, 7% women only, 18% FQHC, 6% RHC, 2% CMHC, 48% Other/Clinic Data pulled February 2019

Strengthen Coordination of Services Population Health Management Health Neighborhood and Community Increase PCMP standards Enhance RAE Authority to support activities 2nd objective: strengthening coordination of services.

Promote Member Choice and Engagement Immediate Enrollment Choice of PCMP PCMP Selection Drives RAE Assignment Health Needs Survey Behavioral Health Services in Primary Care 3rd Objective: Promote Member Choice and Engagement

Pay for Increased Value Pay for Performance Key Performance Indicators Behavioral Health Incentives Flexible Funding Pool Increased RAE Flexibility Alignment with Alternative Payment Model 4th Objective: Pay for increased value

Greater Accountability and Transparency Increase Financial Transparency and Reporting Utilization Management Provider Network Decisions Conflict of Interest in Governance Financial Reporting Increase Funding Tied to Value Matrix Team Management 5th Objective: Greater Accountability and Transparency

RAE Contacts Region Counties Served Entity Contact Information for Providers 1 Archuleta, Delta, Dolores, Eagle, Garfield, Grand, Gunnison, Hinsdale, Jackson, La Plata, Larimer, Mesa, Moffat, Montezuma, Montrose, Ouray, Pitkin, Rio Blanco, Routt, San Juan, San Miguel, Summit Rocky Mountain Health Plans 1-888-282-8801 RAESupport@rmhp.org https://www.rmhp.org/ 2 Cheyenne, Kit Carson, Lincoln, Logan, Morgan, Phillips, Washington, Weld, Yuma Northeast Health Partners 1-800-804-5040 COProviderRelations@beaconhealthoptions.com https://www.northeasthealthpartners.org/ 3 Adams, Arapahoe, Douglas, Elbert Colorado Access Provider Engagement 720-744-5667 or 1-844-430-6684 ProviderRelations@coaccess.com https://www.coaccess.com/ 4 Alamosa, Baca, Bent, Chaffee, Conejos, Costilla, Crowley, Custer, Fremont, Huerfano, Kiowa, Lake, Las Animas, Mineral, Otero, Prowers, Pueblo, Rio Grande, Saguache Health Colorado, Inc. https://www.healthcoloradorae.com/ 5 Denver 6 Boulder, Broomfield, Clear Creek, Gilpin, Jefferson Colorado Community Health Alliance 303-256-1717 (local) or 1-855-627-4685 (toll free) https://www.cchacares.com/ 7 El Paso, Park, Teller 719-598-1540 (local) or 1-855-627-4685 (toll free)

For more information go to: Questions? For more information go to: CO.gov/HCPF/ACCPhase2

ACC Program Specialist Contact Information Emily Berry, MPH ACC Program Specialist Emily.Berry@state.co.us

Thank You!