The healthcare landscape is constantly evolving, and initiatives aimed at improving quality and reducing costs are more critical than ever. One such initiative is the Accountable Care Collaborative (ACC) program, particularly relevant within state Medicaid systems like Health First Colorado (Colorado’s Medicaid program). This guide provides an in-depth look at the ACC program, its goals, objectives, and resources, designed for healthcare providers, stakeholders, and anyone interested in understanding this vital healthcare model.
The Colorado Department of Health Care Policy & Financing (Department) is dedicated to building a Medicaid system that is both high-performing and cost-effective, ultimately enhancing the health outcomes for Coloradans. The second phase of the Accountable Care Collaborative (ACC) builds upon the successes of previous Colorado Medicaid programs to further improve the experience for both Health First Colorado members and healthcare providers.
To stay informed about the latest updates regarding the Accountable Care Collaborative program, you can sign up for regular updates and ensure you never miss crucial information.
Goals and Objectives of the Accountable Care Collaborative Program
The Accountable Care Collaborative program is driven by two primary goals:
- Improve Member Health: The ACC program is fundamentally focused on enhancing the health and well-being of Health First Colorado members.
- Reduce Costs: Alongside improving health, the program aims to create a more cost-effective Medicaid system, ensuring resources are used efficiently.
To achieve these overarching goals, the ACC program operates with several key objectives:
- Integrated Healthcare: To unify physical and behavioral health services under a single accountable entity, promoting holistic care.
- Enhanced Service Coordination: To strengthen the coordination of healthcare services through the advancement of Team-based Care and Health Neighborhoods, ensuring seamless patient journeys.
- Member Empowerment: To promote informed member choice and active engagement in their healthcare decisions.
- Value-Based Provider Payment: To shift the focus from volume to value by paying providers based on the quality and value of care delivered, rather than the quantity of services.
- Accountability and Transparency: To ensure greater accountability across the healthcare system and enhance transparency in operations and outcomes.
Regional Accountable Entities (RAEs) and Their Roles
A cornerstone of the Accountable Care Collaborative program is the establishment of Regional Accountable Entities (RAEs). In November 2017, the Department awarded contracts to seven RAEs, each responsible for specific regions within Colorado. These entities play a crucial role in implementing the ACC program at a regional level.
Below are the Regional Accountable Entities along with their contact information. This information is vital for both healthcare providers and Health First Colorado members seeking to connect with their regional ACC program representatives.
| Region | Entity | Provider Contact Information | Member Contact Information |
|---|---|---|---|
| 1 | Rocky Mountain Health Plans | Email: [email protected] Phone: 1-800-421-6204 |
Phone: 1-888-282-8801 Hours: Monday-Friday, 8:00 a.m. to 5:00 p.m. State Relay: 711 Email: [email protected] Live chat: https://www.rmhp.org |
| 2 | Northeast Health Partners | Address: 9925 Federal Drive, Suite 100, Colorado Springs, CO 80921 Phone: 1-888-502-4191 Email: [email protected] |
Phone: 1-888-502-4189 Care Coordination Line: 1-888-502-4190 Hours: Monday-Friday, 8:00 a.m. to 5:00 p.m. State Relay: 711 Website: Northeast Health Partners Website |
| 3 | Colorado Access | Provider Engagement Phone: 720-744-5667 or 1-844-430-6684 Email: [email protected] |
Phone: 1-800-511-5010 Hours: Monday-Friday, 8:00 a.m. to 5:00 p.m. State Relay: 711 Website: Colorado Access Website |
| 4 | Health Colorado, Inc. | Address: 10855 Hidden Pool Heights, Ste 260, Colorado Springs, CO 80908 Phone: 1-800-804-5040 Email: [email protected] |
Phone: 1-888-502-4185 Care Coordination Line: 1-888-502-4186 Hours: Monday-Friday, 8:00 a.m. to 5:00 p.m. State Relay: 711 Website: Health Colorado Website |
| 5 | Colorado Access | Provider Engagement Phone: 720-744-5667 or 1-844-430-6684 Email: [email protected] |
Phone: 303-368-0038 (Denver County) or 1-855-384-7926 (toll free) Hours: Monday-Friday, 8:00 a.m. to 5:00 p.m. State Relay: 711 Website: Colorado Access Website |
| 6 | Colorado Community Health Alliance | Phone: 303-256-1717 (local) or 1-855-627-4685 (toll free) Contact Us |
Phone: 303-256-1717 or 1-855-627-4685 (toll free) Hours: Monday-Friday, 8:00 a.m. to 5:00 p.m. State Relay: 711 Website: Colorado Community Health Alliance Website |
| 7 | Colorado Community Health Alliance | Phone: 719-598-1540 (local) or 1-855-627-4685 (toll free) Contact Us |
Phone: 719-598-1540 or 1-855-627-4685 (toll free) Hours: Monday-Friday, 8:00 a.m. to 5:00 p.m. State Relay: 711 Website: Colorado Community Health Alliance Website |
Understanding the geographical distribution of these RAEs is crucial. The map below illustrates the regions covered by each entity, providing a visual representation of the Accountable Care Collaborative program’s reach across Colorado.
Provider and Stakeholder Resource Center
To ensure the successful implementation of the Accountable Care Collaborative program, the Department has launched a dedicated Provider and Stakeholder Resource Center. This online hub is regularly updated with essential information, including fact sheets, frequently asked questions (FAQs), webinars, and other resources specifically designed for providers and stakeholders involved in the Accountable Care Collaborative program. It serves as a central point of access for materials that support effective participation and understanding of the ACC initiative.
Member Messaging Resource Center
Effective communication with Health First Colorado members is paramount. The Department has developed a Member Messaging Resource Center to support partners in communicating with members about the ACC program. This resource center offers a variety of communication tools, including sample letters, key talking points, and frequently asked questions, all crafted with Health First Colorado members in mind. Partners are encouraged to utilize these resources to ensure consistent and clear messaging about the ACC program’s evolution and benefits.
Section 1915(b) Waiver and Program Authority
The foundation of the Accountable Care Collaborative program’s authority is the Section 1915(b) Waiver, submitted by the Department to the Centers for Medicare and Medicaid Services (CMS). This waiver is critical as it provides the federal authorization necessary to establish the ACC program as a mandatory initiative. It also enables the creation of regional managed care entities that are responsible for integrating and managing both physical and behavioral health services for members. This waiver replaced the previous Behavioral Health Organization (BHO) waiver, marking a significant step forward in coordinated care. CMS granted approval for the Section 1915(b) Waiver on May 21, 2018, solidifying the ACC program’s framework.
Further details about the waiver can be found in the Section 1915(b) Waiver document.
Stakeholder Engagement and Request for Proposals (RFP) Development
The development of the Accountable Care Collaborative program has been a collaborative effort, heavily involving stakeholders from across Colorado. The Department has actively engaged with providers, advocates, potential vendors, and other stakeholders to gather feedback and refine the ACC program design.
Draft Request for Proposals and Stakeholder Input
The Department initiated a comprehensive stakeholder engagement process to gather input on the draft Request for Proposals (RFP) for ACC Phase II. Over 255 stakeholders, including providers, advocates, and potential vendors, provided valuable comments on the draft RFP and related appendices. This targeted feedback was crucial in shaping the final RFP released in Spring 2017.
Since April 2014, the Department has been in continuous dialogue with stakeholders across the state to inform the development of the next phase of the Accountable Care Collaborative. The Department specifically sought targeted comments on the draft RFP between November 4, 2016, and January 13, 2017, to ensure the formal RFP release was well-informed and addressed key stakeholder considerations.
The Department carefully reviewed and incorporated feedback from the comments received on the draft RFP. Stakeholders generally expressed strong support for integrating behavioral and physical health systems, enhancing member responsiveness, and strengthening health neighborhoods.
While many suggestions were incorporated, some recurring comments could not be directly included in the RFP due to various constraints, such as requests to expand Health First Colorado benefits, alterations to federal managed care regulations, or recommendations more suited for program implementation rather than contractual language.
Key Concepts and Foundational Documents
To provide a deeper understanding of the Accountable Care Collaborative program, the Department has released several key concept documents and fact sheets. These resources are essential for anyone seeking detailed information about the ACC program’s design and operational framework.
- Accountable Care Collaborative Phase II Key Concepts: Provides a comprehensive overview of the core principles and concepts underpinning ACC Phase II.
- ACC Phase II Overview Presentation (updated April 2016): A video presentation offering an updated overview of ACC Phase II.
- ACC Phase II Overview of Key Concepts (updated February 2016): A fact sheet summarizing the key concepts of Phase II. For more detailed information, refer to the Concept Paper.
- ACC Phase II Overview of Stakeholder Engagement: Details the various stages of stakeholder engagement in the development of ACC Phase II.
- ACC Program Improvement Advisory Committee (PIAC) Structure: Explains the structure of the PIAC, a critical committee involved in ACC Phase II development.
- ACC Budget and Legislative Authority Timeline: Outlines the budget and legislative actions related to the ACC program.
- ACC Phase I Request for Proposals (RFP) from 2010: The original RFP from 2010, providing the foundational principles of the ACC Program.
Policy Decisions and Program Details
For specific policy decisions and program details related to the Accountable Care Collaborative program, the following documents are invaluable resources:
- Framework for Behavioral Health Reimbursement: Describes the Department’s framework for behavioral health reimbursement under Phase II.
- Behavioral Health Reimbursement Program Decision: Updates on changes to the Department’s behavioral health service reimbursement proposal.
- ACC Phase II Program Decision Reimbursement for Behavioral Health Services Presentation: A recorded presentation providing an overview of ACC Phase II and behavioral health reimbursement.
- April 2015 ACC Model Details and Policy Decisions: Explains key structural decisions for the ACC Model, including RCCO-BHO Administrative Structure, Regional Maps, and Payment models.
- Q and A from the ACC Model Details and Policy Decisions Document: Answers to frequently asked questions related to the April 2015 policy decisions document.
Stakeholder Meeting Summaries: A History of Collaboration
The development and refinement of the Accountable Care Collaborative program have been marked by extensive stakeholder engagement. The table below lists summaries of meetings hosted or attended by the ACC Phase II Team, illustrating the collaborative approach taken in shaping the program.
| Month & Year | Meeting Type | Resources | Date |
|---|---|---|---|
| December 2016 | Stakeholder Engagement Webinar | Stakeholder Engagement Webinar Slides Recorded Stakeholder Engagement Webinar | December 15, 2016 |
| CDPHE Medical Home Forum | Slide Presentation | December 13, 2016 | |
| Medical Services Board | Slide Presentation | December 9, 2016 | |
| Durango | Slide Presentation | December 3, 2016 | |
| Colorado Springs | Slide Presentation | December 1, 2016 | |
| Alamosa | Slide Presentation | December 1, 2016 | |
| November 2016 | Fort Collins | Slide Presentation | November 30, 2016 |
| State Medical Assistance and Services Advisory Council (NiteMAC) Meeting | Slide Presentation | November 30, 2016 | |
| Pueblo | Slide Presentation | November 30, 2016 | |
| Grand Junction | Slide Presentation | November 30, 2016 | |
| Stakeholder Engagement Webinar | Stakeholder Engagement Webinar Slides Recorded Stakeholder Engagement Webinar | November 29, 2016 | |
| Glenwood Springs | Slide Presentation | November 29, 2016 | |
| Burlington | Slide Presentation | November 29, 2016 | |
| Aurora | Slide Presentation | November 29, 2016 | |
| Stakeholder Engagement Webinar | Stakeholder Engagement Webinar Slides Recorded Stakeholder Engagement Webinar | November 21, 2016 | |
| Golden | Slide Presentation | November 18, 2016 | |
| Greeley | Slide Presentation | November 18, 2016 | |
| Longmont | Slide Presentation | November 17, 2016 | |
| ACC Program Improvement Advisory Committee (PIAC) Meeting | Slide Presentation | November 16, 2016 | |
| June 2016 | ACC Client Perspective, COMMIT Presentation | June 15, 2016 | |
| Provider and Community Issues Subcommittee Meeting | June 9, 2016 | ||
| May 2016 | EPCM Review Findings, MMP Recommendations for Phase II RFP | May 18, 2016 | |
| Provider and Community Issues Subcommittee Meeting | May 12, 2016 | ||
| April 2016 | ACC Program Improvement Committee * | April 20, 2016 | |
| March 2016 | March 2016 Behavioral Heath Transformation Council * | March 14, 2016 | |
| ACC Program Improvement Committee * | March 16, 2016 | ||
| ACC Provider and Community Issues – ACC Program Improvement Committee Subcommittee Meeting | March 10, 2016 | ||
| ACC: Medicare-Medicaid Program Subcommittee | March 3, 2016 | ||
| February 2016 | ACC Program Improvement Advisory Committee | February 17, 2016 | |
| January 2016 | ACC Program Improvement Advisory Committee | January 20, 2016 | |
| December 2015 | Presentation at All Kids Covered Meeting* | December 4, 2015 | |
| ACC Phase II Behavioral Health Community Meeting | December 7, 2015 | ||
| Presentation at Disability Community Representatives / Department Meeting* | December 8, 2015 | ||
| Colorado Medical Home Forum* | December 8, 2015 | ||
| Presentation at Colorado Community Health Network Board Meeting* | December 9, 2015 | ||
| ACC Provider and Community Issues – ACC Program Improvement Committee Subcommittee Meeting* | December 10, 2015 | ||
| Presentation at Medical Services Board* | December 11, 2015 | ||
| ACC Program Improvement Advisory Committee | December 16, 2015 | ||
| November 2015 | ACC: Medicare-Medicaid Program Subcommittee* | November 5, 2015 | |
| ACC Phase II Open Forum | November 10, 2015 | ||
| ACC Provider and Community Issues – ACC Program Improvement Committee Subcommittee Meeting* | November 12, 2015 | ||
| ACC Program Improvement Advisory Committee | November 18, 2015 | ||
| Presentation at State Medical Assistance and Services Advisory Council Meeting* | November 18, 2015 | ||
| Presentation at Alliance/State Forum Meeting* | November 19, 2015 | ||
| Presentation at Colorado Health Institute’s Safety Net Advisory Committee (SNAC) Lab* | November 19, 2015 | ||
| October 2015 | ACC Provider and Community Issues – ACC Program Improvement Committee Subcommittee Meeting* | October 8, 2015 | |
| ACC Program Improvement Advisory Committee | October 21, 2015 | ||
| ACC Health Impact on Lives: Health Improvement – ACC Program Improvement Committee Subcommittee Meeting* | October 28, 2015 | ||
| ACC: Medicare-Medicaid Program Learning Symposium* | October 29-30, 2015 | ||
| September 2015 | ACC Provider and Community Issues – ACC Program Improvement Committee Subcommittee Meeting* | September 10, 2015 | |
| ACC Program Improvement Advisory Committee | September 16, 2015 | ||
| ACC Health Impact on Lives: Health Improvement – ACC Program Improvement Committee Subcommittee Meeting* | September 23, 2015 | ||
| August 2015 | ACC Program Improvement Advisory Committee | August 19, 2015 | |
| July 2015 | Larimer County Meeting | July 8, 2015 | |
| Larimer County Meeting | July 9, 2015 | ||
| Weld County Meeting | July 13, 2015 | ||
| ACC Program Improvement Advisory Committee | July 15, 2015 | ||
| Elbert County Meeting – Kiowa | July 15, 2015 | ||
| June 2015 | ACC Program Improvement Advisory Committee | June 17, 2015 | |
| May 2015 | ACC Program Improvement Advisory Committee | May 20, 2015 | |
| April 2015 | ACC Program Improvement Advisory Committee to discuss ACC Regional map and care coordination * | April 15, 2015 | |
| ACC Provider and Community Issues Subcommittee Meeting to discuss regional map * | April 16, 2015 | ||
| March 2015 | ACC Program Improvement Advisory Committee | March 18, 2015 | |
| January 2015 | Preliminary findings from ACC Request for Information presented to ACC Program Improvement Committee | January 21, 2015 | |
| December 2015 | ACC Program Improvement Advisory Committee | December 17, 2014 | |
| November 2014 | ACC Program Improvement Advisory Committee | November 19, 2014 | |
| October 2014 | Ongoing Stakeholder Engagement Strategy – Discussion at ACC Program Improvement Committee | October 15, 2014 | |
| September 2014 | RFI Question Review – Discussion at ACC Program Improvement Committee | September 17, 2014 | |
| August 2014 | Practice Support Requirements – Discussion at ACC Program Improvement Committee | August 20, 2014 | |
| July 2014 | Care Coordination Requirements – Discussion at ACC Program Improvement Committee | July 16, 2014 | |
| June 2014 | Meeting at RCCO 1 (Durango) | June 19, 2014 | |
| May 2014 | Meeting at RCCO 3 and 5 (Denver) | May 6, 2014 | |
| Meeting at RCCO 1 (Fort Collins) | May 9, 2014 | ||
| Meeting at RCCO 7 (Colorado Springs) | May 27, 2014 | ||
| April 2014 | Meeting at RCCO 1 (Glenwood Springs) | April 14, 2014 | |
| Meeting at RCCO 6 (St. Anthony’s Hospital, Lakewood) | April 15, 2014 | ||
| Strategy Session at ACC Program Improvement Committee | April 16, 2014 | ||
| Meeting at RCCO 4 (Pueblo) | April 22, 2014 | ||
| Meeting at RCCO 2 (Evans) | April 23, 2014 |
2014 Request for Information (RFI): Gathering Early Insights
The 2014 Request for Information (RFI) marked an early and crucial step in defining the future direction of the Accountable Care Collaborative program. The RFI was designed to gather advice and expertise from the public before the development of the formal Request for Proposals (RFP) and contracts.
The Department, in collaboration with the Colorado Health Institute (CHI), conducted numerous public meetings across Colorado to understand stakeholder concerns and aspirations. These discussions played a vital role in shaping the RFI process.
The RCCO RFI was structured as a “question-only” request, featuring targeted questions rather than extensive draft contract language. This approach offered respondents greater flexibility to focus on key areas and allowed their insights to frame the conversation before specific contract requirements were established.
Released in late October 2014, the RFI solicited formal responses due by November 24, 2014. The RFI questions remain accessible on Colorado BIDS and are available for review, providing historical context to the ACC program’s development.
By exploring these resources and understanding the structure of the Accountable Care Collaborative program, stakeholders and providers can effectively engage with and contribute to the ongoing success of this important healthcare initiative in Colorado.
