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 and a fact sheet on performance measures are 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.

Measures:

  • Behavioral Health Engagement
  • Dental Visits
  • Emergency Department Visits
  • Health Neighborhood
  • Prenatal Engagement
  • Well Visits
  • Potentially Avoidable Costs

SFY 20-21 Measure Specifications
Latest Results (July 2018 - June 2021)

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 20-21 Measures:

  • Extended Care Coordination
  • Premature Birth Rate
  • Behavioral Health Engagement for Members Releasing from State Prisons
  • Inpatient Psychiatric Discharges
  • Risk Adjusted Per Member Per Month
  • Medication Adherence (asthma, COPD, depression, hypertension, diabetes, contraception)

SFY 20-21 Measure Specifications
Results from SFY 20-21 are not yet available.

SFY 19-20 Measures:

  • Extended Care Coordination
  • Premature Birth Rate
  • Behavioral Health Engagement for Members Releasing from State Prisons
  • Inpatient Psychiatric Discharges
  • COVID-19 Pandemic Response Plans and Follow Up

SFY 19-20 Measure Specifications
Latest Results (July 2019 - June 2020)

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.

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

SFY 20-21 Measure Specifications
Latest Results (SFY 18-19 and SFY 19-20)

Member Experience

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. 
  • FY18-19

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