weitzman 2013: state health policy initiatives as drivers for improving care outcomes:...
TRANSCRIPT
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 [email protected]