Colorado’s Accountable Care Collaborative Achieves Record Savings

Colorado’s Accountable Care Collaborative Achieves Record Savings

Nearly half a billion in gross savings achieved over five years

Denver, CO – 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.

Since FY 2011-12, the Accountable Care Collaborative has accounted for $490 million in gross savings and a net savings of $139 million.

“We are exactly where we want to be with the Accountable Care Collaborative as we wrap up the fifth year of the program and look forward to its next phase,” said Susan E. Birch, Executive Director of the Department. “In just five years, the Accountable Care Collaborative has shown real progress in creating a health care delivery program that improves health outcomes, better coordinates care and reigns in cost.”

The Accountable Care Collaborative is the core of Health First Colorado, Colorado’s Medicaid program. It promotes improved health for members by delivering care in an increasingly seamless way. It is easier for members and providers to navigate and it makes smarter use of every dollar spent. It works on the principle that coordinated care, with needed community supports, is the best, most efficient way to deliver care to its members.

Some of the program’s administrative costs go towards supporting Colorado’s primary care practices so they can provide additional services to members, transform their practices, grow as medical homes and fully participate in reform initiatives.

Primary care providers receive an additional payment for meeting enhanced primary care standards, such as co-locating physical and behavioral health services or offering care after hours. This strengthens Colorado’s health care infrastructure while creating better access to care for Health First Colorado members. Among enhanced primary care providers in FY 2015-16:

  • 53 percent offered after hours or weekend appointments
  • 50 percent offered on-site behavioral health services
  • 94 percent communicated with patients by telephone or secure email to give timely clinical advice, both during and after office hours
  • 70 percent accepted new Health First Colorado members

The Accountable Care Collaborative’s interventions are making a difference in how Health First Colorado members use health services. This year’s results suggest that members who were in the program longer used more preventive services and fewer high cost services than those in the program for less time. Some highlights:

  • Emergency Room Use: Program members who were enrolled for 7-11 months had a lower rate of emergency room visits than those in the program for 6 months or less. The effect was particularly pronounced for members covered by both Medicare and Medicaid, who often have complex medical conditions and high emergency room use.
  • Follow-Up Care After Hospital Discharge: Nearly two-thirds (63 percent) of Accountable Care Collaborative Medicare-Medicaid Program members in the program for 7-11 months received follow-up care after leaving the hospital, compared to less than half (49 percent) of those enrolled for less time.
  • Well-Child Visits: The rate of annual well-child visits for children enrolled for 7 – 11 months was nearly double that of children in the program less than 7 months (45.0 percent compared to 27.4 percent)

“Colorado continues to set a national example for health reform with the Accountable Care Collaborative,” said Gretchen Hammer, Medicaid Director. “The program makes smarter use of every dollar spent while strengthening health care and community services across the state. As we prepare to launch Phase II of the Accountable Care Collaborative, the program will continue to move toward more coordinated and integrated care that increasingly rewards improved health outcomes.”

For a complete report on the Accountable Care Collaborative’s performance in FY 2015-16, please visit the Department’s website.

About the Accountable Care Collaborative:  The Accountable Care Collaborative is the core of Health First Colorado, Colorado’s Medicaid program. It promotes improved health for members and controls costs by delivering care in an increasingly seamless way. Members of the program receive the regular Health First Colorado benefit package and belong to a Regional Care Collaborative Organization (RCCO) in one of seven geographic regions. These regional organizations ensure care coordination is provided, connect members to primary care (a medical home), specialists and community resources as needed.

FY2015-16 Accountable Care Collaborative Fact Sheet