Medicaid Updates: Governor’s budget proposal, ACC Phase II updates, reattribution of ACC patients

“Medicaid Proposed Budget for 2016-2017 and Provider Rate Impact: Last Monday, November 2nd, Governor John Hickenlooper released his 2016-17 state budget proposal. Because of TABOR amendment limits on state spending growth, the legislature will be forced to cut more than $370 million from the state’s budget for the next state fiscal year. While the Governor’s proposal calls for cuts across all budget categories, there are particularly deep cuts called for in the Medicaid program, including cuts to the primary care reimbursement rates.

Accountable Care Collaborative Phase II Concept Paper: The Accountable Care Collaborative (ACC) is the core delivery system for Colorado Medicaid, with more than 940,000 members enrolled as of August 2015. Since its inception, the ACC has been intended to be an iterative program, driving a steady and sustainable shift in the delivery system from one that incentivizes volume to one that incentivizes value. The Regional Care Collaborative Organization (RCCO) contracts expire in July 2017, creating an opportunity to evolve the program during Phase II of the ACC. In mid-October, HCPF released the ACC Phase II Concept Paper, inviting dialogue with the community. HCPF has organized numerous opportunities to solicit public feedback. Click here to read the Concept Paper, stakeholder forum schedule and more information about the development of ACC Phase II.

Reattribution of Medicaid ACC Patients is Happening Now: Beginning in October 2015, Medicaid has begun to run the attribution algorithm on all systematically-attributed ACC clients on a quarterly basis and allow the system to assign those clients to PCMPs based on claims history over the most recent 12-month period. Clients will be notified of the change to their PCMP assignment via normal notification processes (a letter to the client informing them of the assignment which is sent before the effective date).

This process will initially result in the reassignment of about 78,000 clients. Recognizing the potential financial impact of these reassignments on some providers, Medicaid will be providing the RCCOs with lists of the approximate total number of reassignments by each provider ID. It is anticipated that in subsequent quarters the number of clients reassigned will be significantly lower. Read the entire Policy Statement here for more details.

Read the full Colorado Children’s Heathcare Access Program’s Practice Manager Newsletter for more information on:

• Medicaid Provider Revalidation & Enrollment Update
• Psychiatric Consultation for Children
• Cavity Free at Three Training Opportunity
• ECHO Colorado Learning Series Opportunities” [Source: CCHAP]