Accountable Care Collaborative Program Performance
The Department of Health Care Policy and Financing (HCPF) administers Health First Colorado (Colorado’s Medicaid program), Child Health Plan Plus (CHP+) and other health care programs for Coloradans who qualify. Created in 2011, the Accountable Care Collaborative (ACC) is the primary delivery system for Health First Colorado. Regional Accountable Entities (RAEs) are responsible for promoting member health and well-being by administering the capitated behavioral health benefit, establishing and supporting networks of providers and coordinating medical and community-based services for members in their region. New contracts with the RAEs, ACC Phase III, launched on July 1, 2025.
Monitoring and evaluating the performance of the ACC is an important way for HCPF to ensure greater accountability and provide further transparency about the program. This page includes the following information:
ACC Phase III Evaluation
As part of the transition to ACC Phase III, and with continued input from stakeholders, HCPF has developed a comprehensive evaluation plan. This evaluation will be a deep dive into three focus areas: the behavioral health benefit, primary care, and care coordination. Each focus area contains two scopes of work, which are further broken down into research questions that help us understand our progress towards achieving the five goals of ACC Phase III. The products will include mixed-methods reports that provide insight into how the program is working and the experience of members and providers.
Evaluation plan documents:
The ACC Phase III evaluation plan is regularly discussed during monthly ACC Program Improvement Advisory Committee (PIAC) and subcommittee meetings. These meetings are also open to the public, though your ability to participate may vary. Agendas and other information about joining can be found on the ACC PIAC webpage.
Quality Measure Performance
HCPF uses several sets of health quality performance measures to understand ACC program support for member health. Due to the time it takes for data to be collected and processed, the measures and performance reported on this page are from ACC Phase II. These include Key Performance Indicators (KPIs), Performance Pool incentive measures and Behavioral Health Incentive Program (BHIP) measures. HCPF withholds a portion of the RAE care management per-member-per-month (PMPM) payments to fund the KPI and Performance Pool incentives; there is a separate funding pool for the BHIP measures.
Key Performance Indicators (KPIs)
KPIs provide insight into physical and medical health care utilization. HCPF calculates KPIs on a rolling quarterly basis.
FY 2024-25 Measures:
- Emergency Department Visits (Risk Adjusted)
- Depression Screening and Follow Up
- Oral Evaluations
- Timeliness of Prenatal Care
- Postpartum Care
- Child and Adolescent Well Visits
- Well Child Visits 0-15 Months
- Well Child Visits 15-30 Months
- Risk Adjusted Per-Member-Per-Month (PMPM)
Key Performance Indicator Measure Specifications
Latest Results (KPI data is updated quarterly with approximately a six-month lag)
Performance Pool
The Performance Pool is funded with money not disbursed for KPI performance incentives. It is often used to respond flexibly to timely needs and priorities. Payment is based on annual performance and is not finalized until six to nine months following the end of the fiscal year to allow for claims runout and validation of performance.
FY 2023-24 Measures:
- Extended Care Coordination
- Premature Birth Rate
- Behavioral Health Engagement for Members Releasing from State Prisons
- Asthma Medication Ratio
- Antidepressant Medication Management
- Contraceptive Care for Postpartum Women
Performance Pool Measure Specifications
Latest Results (Performance Pool measures are updated annually)
Behavioral Health Incentive Program (BHIP)
The BHIP measures provide insight into how ACC members access and utilize behavioral health care. Payment is based on annual performance and is not finalized until six to nine months following the end of the fiscal year to allow for claims runout and validation of performance.
FY 2023-24 Measures:
- Engagement in Outpatient Substance Use Disorder (SUD) Treatment
- Follow up within 7 Days after an Inpatient Hospital Discharge for a Mental Health Condition
- Follow up within 7 Days after an Emergency Department Visit for SUD
- Follow up within 30 Days after a Positive Depression Screen
- Behavioral Health Screening or Assessment for Foster Care Members
Behavioral Health Incentive Program Measure Specifications Latest Results (BHIP measures are updated annually)
Operational Data
HCPF monitors various data to understand the ACC, including:
- Caseload and expenditure reports - enrollment figures are available by RAE and by county.
- Consumer Assessment of Health Care Providers and Systems (CAHPS) Surveys – this is a validated tool that evaluates member experience within Medicaid. Members are asked about topics related to health care access, care coordination, and how they are treated by health care providers.
Questions
For more information or questions, please contact hcpf_quality_performance_unit@state.co.us.