Action plan for Medicaid Reform - Accountable Care Collaborative Program

Friday, October 18, 2013 04:00 PM
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The action plan below was approved by the CMS House of Delegates in September 2013.

Continue to support locally based Medicaid innovation in Colorado by the Accountable Care Collaborative (ACC) through physician education/outreach and policy advocacy on:

  1. Better defining patient population through:
    1. Patient attribution:
      1. Advocate for changes to the current rule on patient choice designation in order to make it easier for patients to quickly and efficiently choose a particular physician within the ACC.
      2. Develop messaging to physicians and other stakeholders about how the ACC attribution process works, emphasizing that the focus of the ACC and the attribution process is to keep physicians and patients connected. Encourage current and potential providers to directly contact Regional Care Collaborative Organization (RCCO) contract managers.
      3. Continue to explore policy options to drive patient engagement (incentives/disincentives).
    2. Data analytics

      1. Work with Colorado Hospital Association (CHA) to encourage their members to automate real-time ER data and admission data to RCCOs.
      2. Work with CIVHC to see what roles they may play to improve use of data.
    3. Continuous eligibility

      1. Champion continuous eligibility and necessary legislative changes to ensure appropriate access using the data and patient stories developed by RCCO medical directors.
      2. Deliver a unified, consistent and persistent advocacy message in support of continuous eligibility for adults.
      3. Advocate for use of RCCO networks within Connect for Health Colorado (C4HC) qualified health plan networks; consult with C4HC and Colorado Association of Health Plans (CAHP) regarding how to disseminate information to health plans.
  2. Care delivery and payment reform

    1. Access to specialty care
      1. Partner with the RCCO Medical Directors to leverage enhanced subspecialty access initiatives to increase participation by specialists.
    2. Behavioral health integration

      1. Monitor procurements, State Innovation Model (SIM) grant initiative, and Health Care Policy and Finance policy changes to ensure future changes support integration and do not disrupt RCCO progress or outcomes.
    3. Payment reform

      1. Drive legislative appropriation for payment reforms that enhance specialty care physician participation in the ACC.
    4. Care coordination

      1. Support use of care managers by physicians, hospitals and other care teams; communicate the support through various vehicles.
  3. Ongoing awareness building and collaboration

    1. Develop and deliver messaging to component, specialty medical societies, hospital medical staff, and other organizations about the ACC:  what it is, why it was created, the goals, the metrics, the strategies and tactics to improve it.
    2. Convene a meeting of the specialty society presidents to discuss this report and engage them in this initiative.

Posted in: Medicaid Reform


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