Accountable Care Collaborative Phase II Presented by Emily

Accountable Care Collaborative Phase II Presented by: Emily Berry, MPH Sep-21 1

Our Mission Improving health care access and outcomes for the people we serve while demonstrating sound stewardship of financial resources 2

Long-Term Vision Moving toward more coordinated and integrated care that increasingly rewards improved health 3

Accountable Care Collaborative Improve Health and Reduce Costs Medical Home Regional Coordination Data Ensure Members have a focal point of care. In the ACC, this is referred to as a Primary Care Medical Provider (PCMP). Health First Colorado Members have complex needs and are served by multiple systems. Regional umbrella organizations help to coordinate across systems. Members, providers and the system receive the data needed to make real-time decisions that improve care, increase coordination of services and improve overall efficiencies. 4

Goals • To improve member health & reduce costs Objectives • Join physical and behavioral health under one accountable entity • Strengthen coordination of services by advancing team-based care and health neighborhoods • Promote member choice and engagement • Pay providers for the increased value they deliver • Ensure greater accountability and transparency 5

Regional Accountable Entity Physical Health Care Behavioral Health Care Per Member/ Per Month Behavioral Health Capitation 6

Regions 7

Total Medicaid Caseload January 2019 8% 9% Not Eligible for ACC/ Not enrolled 99166 Rocky Prime/Denver Health 108582 83% Attributed to PCMP 1046236 Data pulled February 2019 8

ACC Enrollment by RAE 300 000 273 479 250 000 200 000 193 647 178 036 170 374 150 000 139 459 130 463 100 000 80 812 50 000 - RAE 1 RAE 2 RAE 3 RAE 4 RAE 5 RAE 6 RAE 7 Data pulled February 2019 9

PCMPs by Type 166 58 Pediatric Only 154 54 Women Only 14 FQHC 410 RHC CMHC Other/Clinic Data pulled February 2019 10

Strengthen Coordination of Services • Population Health Management • Health Neighborhood and Community • Increase PCMP standards • Enhance RAE Authority to support activities 11

Promote Member Choice and Engagement • Immediate Enrollment • Choice of PCMP • PCMP Selection Drives RAE Assignment • Health Needs Survey • Behavioral Health Services in Primary Care 12

Pay for Increased Value • Pay for Performance § Key Performance Indicators § Behavioral Health Incentives § Flexible Funding Pool • Increased RAE Flexibility • Alignment with Alternative Payment Model 13

Greater Accountability and Transparency • Increase Financial Transparency and Reporting § § Utilization Management Provider Network Decisions Conflict of Interest in Governance Financial Reporting • Increase Funding Tied to Value • Matrix Team Management 14

RAE Contacts Region Counties Served Entity Contact Information for Providers 1 Archuleta, Delta, Dolores, Eagle, Garfield, Grand, Gunnison, Hinsdale, Jackson, La Plata, Larimer, Mesa, Moffat, Montezuma, Montrose, Ouray, Pitkin, Rio Blanco, Routt, San Juan, San Miguel, Summit Rocky Mountain Health Plans 1 -888 -282 -8801 RAESupport@rmhp. org https: //www. rmhp. org/ 2 Cheyenne, Kit Carson, Lincoln, Logan, Morgan, Phillips, Washington, Weld, Yuma Northeast Health Partners 1 -800 -804 -5040 COProvider. Relations@beaconhealthoptions. com https: //www. northeasthealthpartners. org/ 3 Adams, Arapahoe, Douglas, Elbert Colorado Access Provider Engagement 720 -744 -5667 or 1 -844 -430 -6684 Provider. Relations@coaccess. com https: //www. coaccess. com/ 4 Alamosa, Baca, Bent, Chaffee, Conejos, Costilla, Crowley, Custer, Fremont, Huerfano, Kiowa, Lake, Las Animas, Mineral, Otero, Prowers, Pueblo, Rio Grande, Saguache Health Colorado, Inc. 1 -800 -804 -5040 COProvider. Relations@beaconhealthoptions. com https: //www. healthcoloradorae. com/ 5 Denver Colorado Access Provider Engagement 720 -744 -5667 or 1 -844 -430 -6684 Provider. Relations@coaccess. com https: //www. coaccess. com/ 6 Boulder, Broomfield, Clear Creek, Gilpin, Jefferson Colorado Community Health Alliance 303 -256 -1717 (local) or 1 -855 -627 -4685 (toll free) https: //www. cchacares. com/ 7 El Paso, Park, Teller Colorado Community Health Alliance 719 -598 -1540 (local) or 1 -855 -627 -4685 (toll free) https: //www. cchacares. com/ 15

Questions? For more information go to: CO. gov/HCPF/ACCPhase 2 16

Contact Information Emily Berry, MPH ACC Program Specialist Emily. Berry@state. co. us 17

Thank You! 18