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Accountable Care Collaborative Public Reporting

One of the primary objectives of the Accountable Care Collaborative is to ensure greater accountability and transparency. The Department provides data and information in three key areas – performance, operations, and finances - for the purpose of collaborating with stakeholders to monitor the success and integrity of the program as well as to identify opportunities for quality improvement. The Department is in the process of building an interactive quality dashboard to show trends for all major performance measures. This dashboard will replace the performance data below when it is available for sharing with stakeholders.

Performance Measures

One way that the Department monitors RAE performance is by utilizing incentive payments to promote performance in key areas that improve population health and access to care. The following three measure sets are intended to drive improved health outcomes for members, build a coordinated community-based approach to care, and reduce costs. The comprehensive set of measure specifications is also available.

Key Performance Indicators (KPIs)

KPIs are measures designed to assess the overall health of the ACC program. They reward the RAEs for improvements to the regional delivery system and in key areas of population health.

SFY22-23 Measures:

  • Behavioral Health Engagement
  • Oral Evaluation, Dental Services
  • Well Visits
  • Prenatal Engagement
  • Emergency Department Visits
  • Risk Adjusted PMPM

Key Performance Indicator Measure Specifications
Latest Results (KPI data is updated quarterly with approximately a 6-month lag)

Performance Pool

Unearned KPI funds become the Performance Pool, a second opportunity for RAEs to earn incentive dollars for performance in population health and system coordination.

SFY 22-23 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 update annually)

Behavioral Health Incentive Program

Behavioral Health Incentive Program measures are intended to incentivize RAEs’ management of the behavioral health capitation particularly for access to mental health and SUD services and appropriate follow up care to promote prevention.

SFY 22-23 Measures:

  • Engagement in Outpatient Substance Use Disorder (SUD) Treatment
  • Follow Up within 7 Days after an Inpatient Hospital Discharge
  • Follow Up within 7 Days after an Emergency Department Visit
  • 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 (Behavioral Health Incentive Program is updated annually)

The CAHPS survey (Consumer Assessment of Healthcare Providers and Systems) 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.

Operational Data

The Department monitors monthly changes in enrollment. Enrollment figures are available by RAE and by county.

ACC Financial Summaries

Annual ACC financial summaries are created from revenue and expense information submitted to the Department from the RAEs and MCOs. Reports are being created and will be posted when completed.

COVID-19 Vaccination Data

The Department is tracking COVID-19 vaccination rates for Health First Colorado members, including disparities by race and ethnicity.

Other Performance Measures

The Department plans to publish additional performance results on public health, health equity, and finances in the near future.

Questions

For more information or questions, please contact Nicole Nyberg, the Quality Performance Manager