News Release: Health First Colorado's Accountable Care Collaborative Achieves Record Savings

The Department of Health Care Policy and Financing (Department) announced today that its Accountable Care Collaborative program saved the state more than $205 million in avoided medical costs during state fiscal year (FY) 2015-16. After accounting for administrative costs and incentive payments to primary care providers and regional care collaborative organizations for meeting performance goals, the program's net savings was nearly $62 million.

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[Source: HCPF]

New ACC Phase II Overview and Behavioral Health Framework Resources

Learn more about plans for Medicaid's Accountable Care Collaborative (ACC) Phase 11:

"For the next few months, the Department is focused on finalizing policy decisions based on stakeholder feedback gathered over the past year and writing the draft request for proposals (RFP). As a result of this commitment of staff resources to writing the RFP, the Department is unable to accommodate all stakeholder requests for meetings or presentations. In the meantime, we have recorded two brief presentations about Phase II to deliver consistent information to the community. We encourage you to access these and other resources available on the ACC Phase II page .

ACC Phase II Overview Recording:
History of ACC
Goals and Objectives
Key Concepts
Procurement Timeline
How to Stay Informed

ACC Phase II Behavioral Health Framework Recording:
ACC Phase II Overview
Behavioral Health Key Concepts
Procurement Timeline
How to Stay Informed"

[Source: HCPF]

ACC Chronic Pain Disease Management Program

The second year of ACC Chronic Pain Disease Management Program will start in April and May with two options:

o Chronic Pain Telehealth Program: Connect PCMPs with a multi-disciplinary team of chronic pain specialists, including behavioral health professionals and pharmacists, to review client cases and learn evidence-based interventions for treating clients with complex conditions.

o Buprenorphine Telehealth Program: Providers licensed to prescribe Buprenorphine/Suboxone will connect with specialists to gain greater insights and experience in treating clients with opioid addiction.

Here is the link to the ECHO flyer on both programs and how practices can get involved!

Accountable Care Collaborative Phase II Update

“Behavioral Health Reimbursement Framework: The Department has developed a high-level model further defining the February 2016 program decision regarding the reimbursement of behavioral health services in ACC Phase II. The Department will retain a capitation payment to support the full continuum of behavioral health services from outpatient therapy to alternative community services to crisis response and hospitalization. One significant change from the current capitation will be limiting the use of the covered diagnosis requirements, where possible, in order to improve access to care.

In addition to the capitation, the Department will be reimbursing more behavioral health services delivered within primary care settings for low acuity and brief episodic conditions. To support integrated care, the Department will define a new set of services for behavioral health providers who work as members of primary care teams.

Additional details on these reimbursement strategies will be made available as they are finalized through the draft Request for Proposal for ACC Phase II. Read more about the behavioral health reimbursement framework here.

February 9 Webinar: FAQs Now Available: On February 9, Medicaid Director Gretchen Hammer and Deputy Medicaid Director Laurel Karabatsos hosted a call and webinar with stakeholders to discuss the ACC Phase II procurement timeline and behavioral health reimbursement program decision. FAQs are available online now.

Questions & Feedback: The Department welcomes input on the future of the ACC. Please submit your questions regarding the ACC Phase II development using this form.” [Source: HCPF]

Accountable Care Collaborative Phase II updates

“In response to feedback from the community and evolving guidance from the Centers for Medicare & Medicaid Services (CMS), the Department has decided to adjust the procurement timeline for Phase II of the ACC and begin the next phase on July 1, 2018.

Behavioral Health Services Payment Methodology: The Department has revised its proposal for reimbursing behavioral health services as outlined in the ACC Phase II Concept Paper. A modified capitation payment methodology will be retained for core behavioral health services. The capitation will be directed to the Regional Accountable Entities who will be responsible for managing the health needs of Medicaid enrollees in their region. For more information about this proposal change, check out our ACC Phase II Program Decision: Reimbursement for Behavioral Health Services fact sheet.” [Source: HCPF]

Accountable Care Collaborative Phase II Update

“The Department is currently reviewing the Accountable Care Collaborative (ACC) Phase II procurement timeline. It is the Department's priority to look at the timeline and revise it, if needed. We have been aware that our original proposed timeline was aggressive given the need for robust stakeholder feedback and discussions with the Centers for Medicare and Medicaid Services (CMS). We have received significant feedback from our partners and want to ensure our steps forward reflect the needs of the Department, our members, the physical and behavioral health provider community, county and community partners and other stakeholders. While evaluating the Phase II procurement timeline, we are also:

• Identifying dependencies,
• Consulting with CMS on the appropriate authority and waivers required to implement the program
• Consulting with the behavioral health community on how best to collaborate,
• Continuing to strengthen our primary care provider engagement, and
• Working with national policy experts

The Department is committed to having a fair, open and transparent process that complies with state procurement rules. When considering organizational requirements and guidelines for submitting proposals for the new Regional Accountable Entities, the Department needs to take into consideration:

• Potential levels of risks associated with different types of organization types (i.e. national organizations, community organizations), and
• Key program principles such as a regional design with some local controls and community approach. [Source: HCPF]

Accountable Care Collaborative Phase II Update

“The Department of Health Care Policy and Financing is looking to consult with stakeholders on the future of the AccountableCare Collaborative (ACC). The ACC is the Department's primary delivery system for health care services and supporting the health of our clients. The Department is committed to creating a high-performing delivery system that is cost-effective, delivers quality services and improves the health of Coloradans. Stay informed on ACC Phase II development by signing up for HCPF’s updates by joiningthe mailing list.

New Resource: The Department has developed a new resource for stakeholders that highlights the key concepts in the ACCPhase II Concept Paper. Check out our two-page KeyConcepts Fact Sheet available at Colorado.gov/HCPF/ACCPhase2.

Submit Your Questions & Feedback: The Department seeks to ensure all stakeholders have access to the same information about the Phase II process, thus we will use the questions we receive via email and at stakeholder meetings to regularly update our frequently asked questions and enhance our ACC Phase II page. Usethis form to submit your questions and feedback online.” [Source: HCPF]

Safety Net Advisory Committee Discusses the Future of the Accountable Care Collaborative

“The Colorado Health Institute's Safety Net Advisory Committee (SNAC) dedicated its final two learning labs of 2015 to studying planned changes for the Medicaid Accountable Care Collaborative (ACC). CHI wants to help people prepare to contribute to the debate over the new ACC in 2016. The two most recent editions of Food for Thought provide a recap of the SNAC Lab discussions. Read the October edition and the November edition, or visit CHI's SNAC Lab page for even more background.

In October's meeting, the Department of Health Care Policy and Financing (HCPF) presented an overview of its plans for the next version of the ACC. The presentation sparked a spirited discussion about the role of public health and oral health in the ACC. In November, evaluators from the Colorado School of Public Health shared early results from their study of the ACC, and HCPF officials returned for more discussion.” [Source: CHI]

2015 Accountable Care Collaborative (ACC) Annual Report

The Department of Health Care Policy and Financing published its 2015 Accountable Care Collaborative (ACC) Annual Report outlining progress made in improving ACC member health, and member and provider experience while containing costs.

ACC Phase II Concept Paper & ACC Reattribution update

ACC Phase II Concept Paper: HCPF published an Accountable Care Collaborative (ACC) Phase II concept paper that describes the proposed program structure and HCPF’s goals for the next iteration of the ACC. It is meant to initiate conversations between HCPF, the Centers for Medicare & Medicaid Services (CMS), and the wide variety of stakeholders who deliver and receive services through Colorado Medicaid. Learn more about upcoming stakeholder opportunities on the ACC Phase II website.

ACC Member Reattribution:  Beginning in November 2015, and ongoing on a quarterly basis, HCPF will reattribute a subset of ACC members who have already been assigned to a Primary Care Medical Provider (PCMP). While most ACC clients are attributed to the correct PCMP, this change will re-assign ACC clients who have changed their utilization patterns (perhaps because of a move or other life event) and whose recent claims data indicates that they are seeing a new provider for most of their primary care. This change will not impact any clients who made an active choice of their PCMP by calling HealthColorado. Affected clients will be notified of the change to their PCMP assignment by mail. [Source: HCPF]

ACC Phase II Stakeholder Meetings and NEW Concept Paper

“The Department of Health Care Policy and Financing (the Department) invites you to participate in guiding the Accountable Care Collaborative Phase II (ACC Phase II). The Overview  and the full Concept Paper (just released) are meant to initiate conversations between the Department and the wide variety of stakeholders who deliver and receive services through Colorado Medicaid.

In order to facilitate dialogue and collaboration, the Department has scheduled a number of public meetings to discuss specific topics as they relate to ACC Phase II. Additional sessions will be announced at a later date that will explicitly address the areas of behavioral health and long-term services and supports. The Department will utilize a listserv as an avenue to distribute meeting announcements and minutes, policy updates, and other relevant documents - to join, send an email to RCCORFP@state.co.us.

Below is the list of currently scheduled meetings. More details about these meetings, and others, can be found here.

ACC Phase II Meetings:

• October 30, 2015, 8:00am-9:00am: ACC: Medicare-Medicaid Program Learning Symposium
• November 5, 2015, 10:00am-12:00pm: ACC: Medicare-Medicaid Program - PIAC Subcommittee Meeting
• November 10, 2015, 5:30pm-7:30pm: Open Forum 1
• November 18, 2015, 9:30am-12:00pm: Program Improvement Advisory Committee (PIAC) Meeting
• November 19, 2015, 12:00pm-2:00pm: SNAC Lab (hosted by the Colorado Health Institute)
• December 8, 2015, 6:00pm-8:00pm: Colorado Medical Home Forum
• December 16, 2015, 9:30am-12:00pm: Program Improvement Advisory Committee (PIAC) Meeting
• January 14, 2016, 6:00pm-8:00pm: Open Forum 2
• January 20, 2016, 9:30am-12:00pm: Program Improvement Advisory Committee (PIAC) Meeting” [Source: HCPF]

Accountable Care Collaborative (ACC) Phase II Overview

“Click here to view a high-level overview of the vision for the next phase of the Accountable Care Collaborative (ACC).  This overview will be followed by a more detailed Concept Paper.  These documents are intended to be a starting point for concrete and productive conversations about the future.” [Source: HCPF]

HCPF Reattributing Accountable Care Collaborative (ACC) Members

“Beginning in October 2015, and ongoing on a quarterly basis, the Department of Health Care Policy and Financing (HCPF) will reattribute a subset of Accountable Care Collaborative (ACC) members who already have been assigned to a Primary Care Medical Provider (PCMP). Most ACC members are attributed accurately to the PCMP who they see for most of their general health care; this change will re-assign ACC members who have changed their utilization patterns (because of a move or other life event) and whose recent claims data indicates that they are seeing a new provider for most of their primary care.

This adjustment to the systematic attribution process will improve the accuracy of a provider’s ACC panel by an average of 17 percent. This change will not impact any clients who made an active choice of their PCMP by calling HealthColorado. Impacted clients will be notified of the change to their PCMP assignment by letter.” [Source: HCPF]

ACC Request for Information: executive summary

“Click here to view the executive summary from the ACC request for information (RFI) conducted late last year.  More information about the next phase of the ACC can be found on the ACC Request for Proposals webpage.  Full text of responses we've received will be published on the webpage in the coming days.” [Source: HCPF]

Accountable Care Collaborative (ACC) Model Details: Questions & Answers

“On April 21st, we released an ACC Model Details and Policy Decisions document.  Since that time, we have received a number of questions about those model details.  Click here to view a document addressing those questions. More information about the next phase of the ACC can be found on the ACC Request for Proposals webpage.” [Source: HCPF]

HCPF Updates: Enhanced rates for E&M and ACC Model Details and Policy Decisions

The Department of Health Care Policy and Financing (HCPF) is pleased to announce enhanced rates for E&M and vaccination codes are now loaded! Effective this week, any qualified E&M or vaccination claim will be paid at the December 2014 Medicare rate.  Providers are not required to attest to providing primary care. Our fiscal agent will also mass adjust all qualified claims paid since January 1st, and repay them at the higher rate.  Due to a limit on how many mass adjustments can be processed at a time, this process will take place over the next few weeks until all providers have been “made whole” for claims submitted since January 1st.

Please note that, although Medicare rates may be adjusted on a quarterly basis, Colorado Medicaid rates will not be adjusted to match these changes. HCPF will keep you posted if the rate benchmark changes.

ACC Model Details and Policy Decisions: Click here to view a document that summarizes three of the key structural decisions that will be in place starting July 1, 2017.  Over the next year, HCPF plans to continue stakeholder outreach and conduct additional research to continue developing the program model.

Parent and Caretaker Relative Eligibility Change FAQ Now Available: Beginning April 1, 2015, the income eligibility level for the Parent and Caretaker Relative MAGI Medicaid category was lowered from 107 percent of the Federal Poverty Level (FPL) to 68 percent FPL. Through a mass update in the Colorado Benefits Management System (CBMS), most parents and caretaker relatives who were enrolled in this category were administratively moved to the Adult MAGI Medicaid category (the category for adults ages 19 to 64 with FPLs up to 133 percent FPL). Parents and caretaker relatives with Medicare are not eligible for the Adult MAGI Medicaid category, but will likely be eligible for the Medicare Savings Program (MSP). A small number of people may not be eligible for MSP, but they will be eligible to apply for private insurance through a SEP through Connect for Health Colorado. HCPF created a Parent/Caretaker Relative Federal Poverty Level Changes Frequently Asked Questions (FAQ) document about this eligibility change.

MSB Recruiting New Member: The board is currently seeking applications for a vacant position and is looking to expand its pool of applicants for consideration. Coloradans who meet the general requirements outlined below are strongly encouraged to submit an application through the Governor’s Office of Board and Commissions:

• Board members must have knowledge of Medical Assistance programs;
• Board members may include a person or persons who have received services through programs administered by HCPF;
• No more than six members can be of the same political party;
• At least one member shall be appointed from each congressional district;
• Membership shall include representation by at least one member who is a person with a disability, a family member of a person with a disability, or a member of an advocacy group for persons with disabilities, provided that the other requirements are met. [Source: HCPF]

Safety Net Advisory Committee (SNAC Lab) Food for Thought: The ACC’s Big Initiatives

“The Accountable Care Collaborative (ACC) represents Colorado’s signature effort to reform how primary care is delivered to Medicaid enrollees. The Colorado Health Institute's latest Safety Net Advisory Committee learning laboratory caught up on some of the top ACC initiatives. This edition of Food for Thought recaps the discussion at the January 22 SNAC Lab, where three experts in different aspects of the ACC spoke about the latest developments.” [Source: Colorado Health Institute]

Chronic Pain Disease Management Program – Informational Webinars

“The Accountable Care Collaborative (ACC) invites you to participate in a new Chronic Pain Disease Management Program modeled after the Project ECHO® (Extension for Community Healthcare Outcomes.) The Chronic Pain Management Program leverages cutting edge telehealth technologies to connect PCMPs to specialists. PCMPs consult directly with specialists regarding client cases and learn best practices for treating clients with a variety of chronic pain conditions.

Select from three Chronic Pain Management Programs. Click here to learn more about the programs.

1. Chronic Pain Telehealth Program
2. Buprenorphine Telehealth Program
3. Pain Management Practice Transformation Learning Collaborative

There are a series of upcoming webinars for interested providers:

• February 23, 8:30-9:30am; http://whoozin.com/VQP-7AG-QN49
• February 26, 12-1pm; http://whoozin.com/6P3-CFF-KYUT
• February 27, 1-2pm; http://whoozin.com/NQF-E6G-M7MX

To learn more and sign-up for the Pain Management Program please e-mail Ági Erickson at ericksa@chc1.com or call 860-347-6971 ext. 3741.” [Source: HCPF]

Provider Recruitment Chronic Pain Disease Management Program

“The Accountable Care Collaborative (ACC) invites you to participate in a new Chronic Pain Disease Management Program. Modeled after the Project ECHO (Extension for Community Healthcare Outcomes) program developed in New Mexico, the Chronic Pain Management Program leverages cutting edge telehealth technologies to connect PCMPs to specialists. PCMPs consult directly with specialists regarding client cases and learn best practices for treating clients with a variety of chronic pain conditions.

The Department will sponsor approximately 50 PCMPs to serve as telehealth pioneers for Colorado. Participation in ECHO-like program is easy and the benefits for providers and their clients are significant: click here to view a flier for more information. To learn more & sign-up for the Pain Management Program please e-mail jd.belshe@state.co.us by January 15th.” [Source: HCPF]

ACC: MMP materials, Accountable Care Collaborative: Medicare-Medicaid Program

“We are 4 months into the implementation of the statewide Accountable Care Collaborative: Medicare-Medicaid Program (ACC: MMP) and we wanted to remind you of all the resources we have created to help clients, providers, advocates, etc. better understand the program. Check out our new website for all the resources:

• ACC: MMP - Program Information, webinars, and trainings (Click and expand the “Accountable Care Collaborative (ACC): Medicare-Medicaid Program training and…” box)
• ACC: MMP - Information for Clients
• ACC: MMP – Advisory Subcommittee Page
• ACC: MMP – Stakeholder meeting information

General Program Description:
Colorado is one of 15 states participating in a Centers for Medicare and Medicaid Services (CMS) demonstration to test models of financial alignment between the Medicare and Medicaid programs. The goal of the demonstration is to improve health outcomes and client experience while reducing costs and unnecessary services for full-benefit Medicare-Medicaid enrollees. To implement this program, Colorado will enroll Medicare-Medicaid client’s into the Accountable Care Collaborative (ACC) program, which is Colorado’s primary healthcare delivery system.

The Accountable Care Collaborative: Medicare-Medicaid Program (ACC: MMP) is a program for people eligible for both Medicare and Medicaid. It gives members their full benefits and the freedom to choose their own doctor while emphasizing coordinated care and good health outcomes. A Primary Care Medical Provider (PCMP) serves as a medical home that leads the member’s health care team, connecting members to health care and tracking their progress and outcomes.

ACC members and their PCMPs belong to a Regional Care Collaborative Organization (RCCO). The RCCO has a network of both medical and non-medical service providers to help ACC members get what they need to be healthy. RCCOs also work with PCMPs to coordinate the care of ACC: MMP members with complex health needs. Care coordinators help members find the right health care, learn self-care, and find non-medical services like housing, food and fuel assistance. There are seven RCCOs in the state.

The RCCO helps providers, too. RCCOs make it easier for providers to navigate the Medicaid and Medicare systems, and improve their practices so providers can focus on delivering care. The RCCO also tracks trends in health services and health outcomes, so PCMPs can be rewarded for good outcomes and not just for delivering services.” [Source: HCPF]