Colorado

The CPCi is a nationwide, multipayer project from the CMS Innovation Center providing enhanced compensation for high-quality, coordinated, patient-centered care to Medicare patients. Practices were selected through a competitive application process based on their use of health information technology, ability to demonstrate recognition of advanced primary care delivery by accreditation bodies, service to patients covered by participating payers, participation in practice transformation and improvement activities, and diversity of geography, practice size and ownership structure.

Colorado is using an Accountable Care Collaborative (ACC) model to expand medical home services for their adult and pediatric Medicaid population. Under this model, primary care medical providers (PCMPs) contract with 7 regional care collaborative organizations (RCCOs) to provide medical home services to Medicaid enrollees.The goal of the ACC is to have every member linked with a primary care medical provider (PCMP) as his or her central point of care, and the PCMPs are directly responsible for ensuring timely access to primary care for ACC members.

Colorado was granted a Pre-Testing Award from the Centers for Medicare & Medicaid Services (CMS) to develop a model for integrating primary care and behavioral health, and sustaining it through outcomes-based payments. The goal is for 80 percent of Coloradans to have access to coordinated systems of care that provide integrated behavioral health care in primary care settings by 2019. In December of 2014, (CMMI) awarded Colorado with $65 million over 48 months in State Innovation Model (SIM) funding to implement its State Health Innovation Plan.

The Medical Homes for Children Program through the Colorado Department of Health Care Policy and Financing (HCPF) provides participating primary care practices pay for performance reimbursement for preventive care visits for children receiving Medicaid. Practices must receive recognition through NCQA or through the Colorado Children’s Healthcare Access Program (CCHAP).

Colorado and New Mexico formed an Interstate Alliance of School-Based Health Centers (SBHCs) to integrate school-based health care into a medical home approach to improve the health care of underserved school-aged children and adolescents. Colorado and New Mexico also plan to utilize SBHCs to improve the delivery of care within the school setting and to improve screening, preventive services, and management of chronic conditions. The goal will also be to educate adolescents to encourage more involvement in their own health care, and follow-up with primary care providers.

The three-year Colorado Family Medicine Residency Patient-Centered Medical Home Project is funded by The Colorado Health Foundation. It aims to facilitate the transformation of the family medicine residency practices into Patient-Centered Medical Homes (Patient-Centered Medical Homes) and redesign the residency's curricula to train physicians in the core competencies of Patient-Centered Medical Home care delivery.

Denver Health and Hospital Authority is receiving a CMS Health Care Innovation Award to create an ambulatory care model that will provide individualized care for patients' medical, behavioral and social needs. This model will target low income children and adults with diverse health care needs. It will coordinate care and offer self-care support between visits, enabled by HIT and team-based patient navigators, and will integrate physical and behavioral health services in existing primary care settings and newly created high risk clinics.

Cigna and New West Physicians, P.C., a large physician group in Denver, launched a collaborative accountable care initiative to expand patient access to health care, improve care coordination, and achieve the triple aim of improved health outcomes (quality), lower total medical costs and increased patient satisfaction. Critical to the program's benefits are registered nurses, employed by New West Physicians, who serve as clinical care coordinators and help patients with chronic conditions or other health challenges navigate the health care system.

The Collaborative Accountable Care program links doctors, hospitals and a single health plan together with the goal of reducing health care costs by improving patients' health. The principles of the patient-centered medical home are the foundation of Cigna's collaborative accountable care initiatives. Cigna then builds on that foundation with a strong focus on collaboration and communication with medical organizations.