Colorado

Children’s National Health System has been named a recipient of a Center for Medicare & Medicaid Innovation (CMMI) award to improve health care delivery for children with complex medical needs.  The grant, aimed at advancing care coordination models, was awarded to the Children’s Hospital Association (CHA) and 10 pediatric hospital partners.

The combined Aetna Whole Health – Colorado Front Range network will launch in January 2015 and provide Aetna members access to more than 800 primary care physicians, 4,000 specialists and 31 hospitals throughout the Colorado Front Range. The accountable care collaboration gives employers better health care options for their employees, and will feature a new model of health care delivery designed to offer:

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

This four-year program aims to discover practical models to integrate mental health, substance use, and primary care services for people whose health problems and health care needs span physical, emotional, and behavioral domains. The program has funded 11 demonstration projects that have been organized as a set of diverse comparative case studies and will be linked to support cross-project learning.

CMS approved a Memorandum of Understanding (MOU) with the state of Colorado in February 2014. The Colorado Department of Health Care Policy and Financing is partnering with the Centers for Medicare & Medicaid Services to implement a

SHAPE is a 3-year project that aims to examine the effect of paying for the integration of behavioral health and primary care through a global payment. Actuarial modeling will study its sustainability and benefit to the practice and community.  In determining the payment to integrated providers, the following factors will be considered:

Cigna and Physician Health Partners launched a collaborative accountable care initiative to improve patient access to health care, enhance care coordination and achieve the “triple aim” of improved health, affordability and patient experience. The program became effective January 1, 2014 and includes Denver-area doctors affiliated with Primary Physician Partners  and South Metro Primary Care .