Colorado Medicaid program achieves $100 million savings,  invests $14 million in providers

Tuesday, November 18, 2014 03:01 PM

The Department of Health Care Policy and Financing announced it has achieved about $100 million in gross savings on medical services with its Accountable Care Collaborative program, more than double the savings achieved by the program last fiscal year. After accounting for payments to providers and regional care collaborative organizations, the program’s net savings for state fiscal year (FY) 2013-14 was approximately $31 million.

HCPF reports in a press release that the program reinvested approximately $14 million into providers. This is up from $6 million in FY 2012-13 and $3 million in FY 2011-12.

“The ACC is changing the way we deliver health care,” said Susan E. Birch, MBA, BSN, RN, executive director, in a press release. “It’s a nationally recognized model that puts clients and wellness at the center of care and strengthens Colorado’s health care infrastructure, while also saving taxpayer dollars by avoiding unnecessary services.”

The ACC program is a central part of Medicaid reform that changes the incentives and health care delivery processes for providers from one that rewards a high volume of services to one that holds them accountable for health outcomes. HCPF brought the program to state lawmakers as a budget reduction item in 2009 with the expectation that the program would not only pay for itself, but reduce expenditures in the future.

Clients in the ACC receive the regular Medicaid benefit package and belong to a Regional Care Collaborative Organization (RCCO). The ACC program has seven geographical regions, each served by a specific RCCO. These regional organizations provide care coordination and connect members to primary care, specialists and community resources as needed. Approximately 610,000 clients were enrolled in the ACC at the end of FY 2013-14.

In the release, Deputy Medicaid Director Laurel Karabatsos said the first two years of savings were based on serving a smaller number of people. Now the program covers 60 percent of Colorado Medicine beneficiaries. “The fact that we continue to save money shows that the program is working, and can work on a large scale,” she said.

In FY 2013-14, HCPF had four key performance indicators to measure improvement among clients enrolled in the ACC, compared to clients not enrolled or enrolled for fewer than six months: 30-day hospital readmissions, high-cost imaging, emergency room utilization, and well-child visits. Clients enrolled in the ACC performed better than other populations in all four metrics.