Weitzman 2013: State Health Policy Initiatives as Drivers for Improving Care Outcomes:...

Colorado Department of Health Care Policy and Financing

Susan E. Birch, Executive DirectorColorado Department of Health Care Policy and Financing

May 16, 2013

State Health Policy Initiatives as Drivers for Improving Care Outcomes: Colorado’s Accountable Care Collaborative

Colorado Department of Health Care Policy and Financing

Medicaid Expansion Bill Signing

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Colorado Department of Health Care Policy and Financing

Who We Serve

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Colorado Department of Health Care Policy and Financing

The State of Health: Colorado’s Commitment to Become the Healthiest State

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Colorado Department of Health Care Policy and Financing

Accountable Care Collaborative

Colorado Department of Health Care Policy and Financing

RCCO Map

Colorado Department of Health Care Policy and Financing

Accountable Care CollaborativeFirst Year Results

• FY11-12 Department reduced Medicaid health costs by $20 million

• Returned nearly $3 million to state and federal taxpayers since its inception

Indicators – ACC Clients• Hospital Readmissions 8.6% reduction• Emergency Room Utilization .23% increase• High-Cost Imaging 3.3% reduction

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Colorado Department of Health Care Policy and Financing

Reforming Payment

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Graphic Courtesy of Colorado Health Institute

Colorado Department of Health Care Policy and Financing

PCMP & RCCO Payment • FFS reimbursement to PCMPs for medical services

• Per Member Per Month (PMPM) payment to PCMP for medical home services*

• PMPM payment to RCCO’s for PCMP support and member care coordination

• Incentive Payments

*Children’s Medical Home providers do not receive the PMPM because they are already receiving the enhanced rate.

Colorado Department of Health Care Policy and Financing

Next Steps

•Enhanced Integration• Physical, Behavioral, Dental, Public Health,

Long Term Services and Supports•Medicare-Medicaid Enrollees•Payment Reform – HB 12-1281•Shared Savings•Enhanced Data Collection and Sharing

Colorado Department of Health Care Policy and Financing

Questions

Susan E. BirchExecutive DirectorColorado Department of Health Care Policy & Financing 1570 Grant Street Denver, CO 80203 Susan.Birch@state.co.us