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Accountable Care Collaborative
Phase II Update
May 27, 2016                                                                                       
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May ACC Phase II Update

The Department of Health Care Policy and Financing (Department) is working with our partners to develop the next phase of the Accountable Care Collaborative (ACC). Phase II of the ACC seeks to leverage the proven successes of Colorado Medicaid's programs to enhance the Medicaid client and provider experience. Learn more about ACC Phase IIThe goal of ACC Phase II it to improve health and control costs by:
  • Fostering the integration of primary care and behavioral health services,
  • Improving coordination of services by advancing team-based care, Health Teams, and Health Neighborhoods,
  • Promoting client choice and engagement,
  • Paying providers for the increased value they deliver, and 
  • Ensuring greater accountability and transparency.
Update of Request for Proposals
The Department began the ACC reprocurement with a robust Request for Information (RFI) process , which yielded a wealth of information and recommendations. The information gathered in the RFI continues to be used to guide work on the current and future ACC program.
As the Department began designing the program, the Department's ACC Program Improvement Advisory Committee (PIAC)  and other stakeholder groups were asked for input on major program decisions. To date many of the Department's conversations with the stakeholder community have been designed around a specific topic or component. We encourage all interested parties to see the past meeting summaries on the ACC Phase II site .
Department plans to engage the stakeholder community once again to provide additional feedback and fine-tune elements of program design through a public review period of the draft RFP being released in fall 2016. Very few states release a draft RFP for public comment but we are committed to ensuring a transparent process and believe the draft RFP is a valuable way to provide the stakeholder community the opportunity for input on the entire program model. Between now and the release of the draft RFP, the Department will not regularly solicit feedback as we work to refine the full model .

ACC Program Improvement Advisory Committee Recommendations
The Department would like to acknowledge the commitment ofthe ACC Program Improvement Advisory Committee (PIAC) and its subcommittees for offering thoughtful input and feedback on core components of the next iteration of the ACC.
The Department would like to highlight some of the recommendations received in the following areas through numerous PIAC and subcommittee meetings:
Care Coordination:
  • More aspects of care coordination should be standardized statewide, including: stratification, criteria for delegation, and the definition of care coordination, and national standards like NCQA should be aligned with as much as possible
  • Stratification should take into account the differences between adults and children and the Department should consider use of the Association of Maternal & Child Health Programs care coordination standards for children and youth with special healthcare needs
  • Measurement of care coordination should take the delivery setting (RCCO or delegate) into consideration and should focus on outcomes rather than process
Measurement of Client Experience:
  • The RAEs should be required to fund and administer patient/client surveys
  • Surveys should be analyzed at the provider and regional level
  • Survey results should be shared in public forums and on the Department's website
  • The Department and the RAEs should develop a performance based incentives to improve performance in the area of client/patient experience
Data Sharing:
  • The Department should create contractual requirements for sharing information between the different entities involved in the ACC program
  • Real-time data should be used whenever possible
The development of the ACC program is an iterative process and there will continue to be opportunities to provide input for improvement. We look forward to weighing this feedback, and others provided by the stakeholder community, as we develop the draft RFP that will be releases for public comment in fall 2016.

Behavioral Health Update
As you may know, in December 2015, the Department convened a meeting with behavioral health stakeholders to discuss the proposed ACC Phase II model and solicit feedback. Stakeholders made comments and asked questions on the Department's proposed fee-for-service model which was then categorized under the following themes:
  • Health Care Delivery (Access/Utilization Management/Care Coordination)
  • Payment
  • Quality Improvement/Quality Assessment/Provider Credentialing
  • Behavioral Health Information Data Sharing (42 CFR and HIPAA), and
  • Special Populations
The Department then worked with the Colorado Behavioral Health Council and other established stakeholder groups who were tasked with developing solutions in response to the questions. The work of those groups in combination with the Department's continued development of the model, resulted in the program decision to retain a modified capitation payment methodology for core behavioral health services. The Department released details of the new model in February 2016 .
Some questions posed by stakeholders at the December 2015 behavioral health stakeholder meeting were not addressed or solved by the Department's decision to retain a modified capitated payment . The outstanding questions were posed to a group of stakeholders at the March 2016 Behavioral Health Transformation Council meeting following a Department presentation on the revised ACC Phase II behavioral health reimbursement model.  The questions and a summary of the feedback received are available on the ACC Phase II site. 
Staying Informed
We encourage all interested parties to check out our ACC Phase II site for the latest information: .

As a reminder, ACC Phase II Team has recorded two brief presentations about Phase II to deliver consistent information to the community. We encourage you to share theses resources and others available on our ACC Phase II page with your networks.