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

2. HCPF Mission

3. 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

4. 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

5. 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.

6. 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

7. 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)

8. Total Medicaid Caseload January 2019
Data pulled February 2019

9. ACC Enrollment by RAE
Data pulled February 2019

10. 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

11. 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.

12. 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

13. 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

14. 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

15. 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 2
Cheyenne, Kit Carson, Lincoln, Logan, Morgan, Phillips, Washington, Weld, Yuma
Northeast Health Partners 3
Adams, Arapahoe, Douglas, Elbert
Colorado Access
Provider Engagement or 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. 5
Denver 6
Boulder, Broomfield, Clear Creek, Gilpin, Jefferson
Colorado Community Health Alliance
(local) or (toll free) 7
El Paso, Park, Teller
(local) or (toll free)

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

17. ACC Program Specialist
Contact Information
Emily Berry, MPH
ACC Program Specialist

18. Thank You!