The landscape of healthcare is constantly evolving, particularly when it comes to serving vulnerable populations through programs like Medicaid and Medicare. In Colorado, the Department of Health Care Policy & Financing is proactively addressing these complexities through the Accountable Care Collaborative (ACC). This initiative aims to create a more efficient, high-quality, and cost-effective healthcare system for Health First Colorado members, the state’s Medicaid program.
To ensure the ACC program’s success and continuous improvement, knowledge sharing and stakeholder engagement are critical. A key component of this effort is the Accountable Care Collaborative Medicare-medicaid Program Learning Symposium. This event serves as a vital platform for stakeholders to convene, share insights, and learn best practices in integrated care models, particularly those involving Medicare and Medicaid beneficiaries.
The Goals and Objectives of the Accountable Care Collaborative
The Accountable Care Collaborative is built upon a foundation of clear goals and objectives, all centered around enhancing the healthcare experience for both members and providers. The primary goals include:
- Improving Member Health: At its core, the ACC is dedicated to improving the overall health outcomes of Health First Colorado members. This involves proactive and preventative care, addressing both physical and behavioral health needs.
- Reducing Costs: Simultaneously, the ACC strives to create a more cost-effective Medicaid system. This is achieved through efficient resource allocation, preventative care to reduce costly emergency interventions, and value-based payment models.
To achieve these overarching goals, the ACC is guided by specific objectives:
- Integrating Physical and Behavioral Health: Recognizing the interconnectedness of physical and mental well-being, the ACC aims to unify physical and behavioral health services under a single accountable entity. This integrated approach ensures holistic care for members.
- Strengthening Service Coordination: The ACC promotes team-based care and the development of Health Neighborhoods. These strategies enhance the coordination of various services, ensuring members receive seamless and comprehensive care.
- Promoting Member Choice and Engagement: Empowering members to actively participate in their healthcare journey is a priority. The ACC emphasizes member choice and engagement in care decisions, fostering a patient-centered approach.
- Value-Based Provider Payment: Shifting away from traditional fee-for-service models, the ACC focuses on paying providers for the value they deliver. This encourages quality care and positive health outcomes, rather than just the volume of services.
- Ensuring Accountability and Transparency: Transparency and accountability are essential for a successful public program. The ACC is committed to greater accountability and transparency in its operations and outcomes.
Regional Accountable Entities (RAEs) and Localized Care
To effectively implement the ACC across Colorado, the state is divided into seven regions, each managed by a Regional Accountable Entity (RAE). These RAEs are responsible for coordinating care within their designated regions and are crucial to the ACC’s operational structure. For each region, specific entities have been awarded contracts to serve as RAEs. These entities are responsible for:
- Managing provider networks within their region.
- Implementing care coordination strategies.
- Ensuring access to quality healthcare services for Health First Colorado members.
The table below provides contact information for each RAE, including resources for both providers and Health First Colorado members:
| Region | Entity, Proposals and Contracts | Contact Information for Providers | Contact Information for Health First Colorado Members |
|---|---|---|---|
| 1 | Rocky Mountain Health PlansProposalContract | Email: [email protected]Phone: 1-800-421-6204 | 1-888-282-8801Monday-Friday, 8:00 a.m. to 5:00 p.m.State Relay: 711 for callers with hearing or speech disabilitiesEmail: [email protected]Live chat at: https://www.rmhp.org |
| 2 | Northeast Health PartnersProposalContract Attachments: | 9925 Federal Drive, Suite 100Colorado Springs, CO 80921Phone: 1-888-502-4191 Email:[email protected] | 1-888-502-4189Care Coordination Line: 1-888-502-4190Monday-Friday, 8:00 a.m. to 5:00 p.m.State Relay: 711 for callers with hearing or speech disabilitiesNortheast Health Partners Website |
| 3 | Colorado AccessProposalContract | Provider Engagement720-744-56671-844-430-6684Email: [email protected] | 1-800-511-5010Monday-Friday, 8:00 a.m. to 5:00 p.m.State Relay: 711 for callers with hearing or speech disabilitiesColorado Access Website |
| 4 | Health Colorado, Inc.ProposalContract Attachments: | 10855 Hidden Pool Heights, Ste 260Colorado Springs, CO 80908Phone: 1-800-804-5040 Email:[email protected] | 1-888-502-4185Care Coordination Line: 1-888-502-4186Monday-Friday, 8:00 a.m. to 5:00 p.m.State Relay: 711 for callers with hearing or speech disabilitiesHealth Colorado Website |
| 5 | Colorado AccessProposalContract | Provider Engagement720-744-56671-844-430-6684Email: [email protected] | 303-368-0038 (Denver County) or 1-855-384-7926 (toll free)Monday-Friday, 8:00 a.m. to 5:00 p.m.State Relay: 711 for callers with hearing or speech disabilitiesColorado Access Website |
| 6 | Colorado Community Health AllianceProposalContract | Phone: 303-256-1717 (local)or 1-855-627-4685 (toll free)Contact Us | 303-256-1717 or 1-855-627-4685 (toll free)Monday-Friday, 8:00 a.m. to 5:00 p.m.State Relay: 711 for callers with hearing or speech disabilitiesColorado Community Health Alliance Website |
| 7 | Colorado Community Health AllianceProposalContract | Phone: 719-598-1540 (local)or 1-855-627-4685 (toll free)Contact Us | 719-598-1540 or 1-855-627-4685 (toll free)Monday-Friday, 8:00 a.m. to 5:00 p.m.State Relay: 711 for callers with hearing or speech disabilitiesColorado Community Health Alliance Website |
A map displaying the seven regions of the Colorado Regional Accountable Entities (RAEs) for the Accountable Care Collaborative.
The Importance of the Medicare-Medicaid Program Learning Symposium
The Accountable Care Collaborative Medicare-Medicaid Program Learning Symposium is a crucial event that underscores the commitment to continuous learning and improvement within the ACC framework. These symposiums, like the one held in October 2015, serve multiple vital functions:
- Knowledge Dissemination: Symposiums are designed to share the latest research, best practices, and policy updates related to integrated care models, particularly those serving individuals who are dually eligible for both Medicare and Medicaid.
- Stakeholder Collaboration: Bringing together providers, administrators, policymakers, and other stakeholders creates a collaborative environment. This fosters open communication, shared problem-solving, and the development of innovative solutions.
- Learning and Skill Enhancement: Participants gain valuable knowledge and skills through presentations, workshops, and networking opportunities. This contributes to a more informed and capable healthcare workforce.
- Program Refinement: Feedback and insights gathered at symposiums directly inform the ongoing refinement and improvement of the ACC program. This ensures the program remains responsive to the evolving needs of members and providers.
The Department actively encourages stakeholder engagement through various resource centers:
- Provider and Stakeholder Resource Center: This online hub offers fact sheets, FAQs, webinars, and other resources specifically for providers and stakeholders involved in the Accountable Care Collaborative.
- Member Messaging Resource Center: To ensure clear communication with Health First Colorado members, this resource center provides messaging materials, including sample letters, talking points, and FAQs, designed to keep members informed about the ACC and its benefits.
Key Resources and Further Information
For those seeking deeper insights into the Accountable Care Collaborative and related initiatives, the Department provides a wealth of resources:
- Section 1915(b) Waiver: This waiver, approved by the Centers for Medicare and Medicaid Services (CMS), provides the federal authority for the ACC program and the creation of Regional Accountable Entities. Details of the waiver are publicly accessible.
- Request for Proposals (RFP) Development: Information related to the Request for Proposals process for ACC Phase II, including draft RFPs and stakeholder feedback, is available. This demonstrates the Department’s commitment to transparency and stakeholder input in program design.
- Key Concepts and Fact Sheets: A range of fact sheets and concept papers are published, offering overviews of key aspects of the ACC, including program objectives, stakeholder engagement strategies, and budget timelines.
- Stakeholder Meeting Summaries: Records of stakeholder meetings, including slide presentations and webinar recordings, are available, providing a historical perspective on the program’s development and ongoing dialogue with stakeholders.
- 2014 Request for Information: The initial Request for Information (RFI) from 2014, along with related questions and background information, is accessible, illustrating the early stages of program development and stakeholder consultation.
Conclusion: Advancing Integrated Care Through Collaboration and Learning
The Accountable Care Collaborative in Colorado represents a significant commitment to improving healthcare for Medicaid members. The Accountable Care Collaborative Medicare-Medicaid Program Learning Symposium exemplifies the proactive approach taken by the Department to foster collaboration, knowledge sharing, and continuous improvement. By engaging stakeholders and providing comprehensive resources, the ACC is paving the way for a more integrated, efficient, and patient-centered healthcare system.
To stay informed about the latest updates and resources related to the Accountable Care Collaborative, individuals are encouraged to sign up for regular updates.
