Accountable Care Collaborative Phase II

The Department of Health Care Policy & Financing (Department) is committed to creating a high-performing, cost-effective Medicaid system that delivers quality services and improves the health of Coloradans. The second iteration of the Accountable Care Collaborative (ACC) leverages the proven successes of Colorado Medicaid's programs to enhance the Health First Colorado (Colorado's Medicaid program) member and provider experience.

Goals of the Accountable Care Collaborative

• Improve member health
• Reduce costs

Objectives of the Accountable Care Collaborative

• Join physical and behavioral health under one accountable entity
• Strengthen coordination of services by advancing Team-based Care and Health Neighborhoods
• Promote Member choice and engagement
• Pay providers for the increased value they deliver
• Ensure greater accountability and transparency

Regional Accountable Entities

In November 2017, the Department announced the awards for the seven Regional Accountable Entity (RAE) contracts. The Department is pleased to announce the below entities have been awarded contracts. The following can be found in the drop down below:

1. Contact Information of each Regional Accountable Entity
2. Proposal Submitted by each Regional Accountable Entity
3. Executed Contract for each Regional Accountable Entity

Provider and Stakeholder Resource Center

The Department has published and will regularly update information on this Provider and Stakeholder Resource Center. This resource center includes fact sheets, FAQs webinars and other resources for providers and stakeholders the Accountable Care Collaborative.

Member Messaging Resource Center

The Department has developed and will regularly update this Member Messaging Resource Center. This resource center includes messaging for Health First Colorado members that can be used by our partners including sample letters, talking points, frequently asked questions, and more‚ all developed with our Health First Colorado members in mind. We ask our partners to use these resources when communicating with Health First Colorado members about the next iteration of the ACC.

Section 1915(b) Waiver

The Department recently submitted to the Centers for Medicare and Medicaid Services (CMS) the Section 1915(b) Waiver Proposal for ACC Phase II. This waiver provides the federal authority to establish the ACC as a mandatory program and to create single regional managed care entities responsible for promoting physical and behavioral health for members. This waiver replaces the previous Behavioral Health Organization (BHO) waiver. CMS approved the waiver on May 21, 2018.

Section 1915(b) Waiver

Draft Request for Proposals and Stakeholder Comments

The Department would like to thank the more than 255 providers, advocates, potential vendors and other stakeholders who provided comments on the draft Accountable Care Collaborative Phase II draft request for proposals (RFP) and corresponding appendices. The Department sought targeted comments on the draft RFP from stakeholders to help refine the content for the formal release of the RFP in the spring 2017.

Since April 2014, the Department has been in ongoing conversations with stakeholders across the state regarding the next iteration of the Accountable Care Collaborative. The Department sought targeted comments between November 4, 2016 and January 13, 2017 on the draft RFP from stakeholders to help refine the content for the formal release of the RFP in the spring 2017. The snapshot below shows the Department's outreach efforts on the draft RFP.

The Department has worked diligently to distill, and where possible, incorporate comments received on the draft RFP.

Respondents expressed in their comments overall support for increasing integration of the behavioral and physical health systems, increased focus on member responsiveness, and increased steps to build the health neighborhood.

The Department was able to make some updates to the RFP and encourages stakeholders to review the final scope of work in the RFP for additional details. Some reoccurring comments, however, were unable to be incorporated in to the RFP by the Department including:

• Requests for expanding Health First Colorado benefits
• Requests for alterations to federal managed care regulation language and requirements, including number of deliverables
• Requests for prescriptive requirements impacting specific target populations
• Recommendations that are more appropriate for implementation rather than contracting

Key Concepts and Fact Sheets

Accountable Care Collaborative Phase II Key Concepts

In mid-October 2015, the Department published the ACC Phase II Concept Paper. The Concept Paper provided a venue to share some of the Department's proposed plans for reforming Medicaid and initiate conversations with federal, state, and local partners. From the onset, the Department planned to adjust some proposed policies based on further research and stakeholder feedback. Current policy and program decisions can be found below under the heading ACC Model Details, Policy and Program Decisions, Whitepapers and Fact Sheets.
ACC Phase II Overview Presentation (updated April 2016)

ACC Phase II Overview of Key Concepts (updated February 2016): This fact sheet provides a brief overview of the Phase II key concepts. For additional information please refer to the Concept Paper.

ACC Phase II Overview of Stakeholder Engagement: This fact sheet provides a brief overview of the various phases of stakeholder engagement related to the ACC Phase II.

ACC Program Improvement Advisory Committee (PIAC) Structure: This fact sheet provides an overview of the PIAC structure. This committee and subcommittees have been an integral part of the development of ACC Phase II.

ACC Budget and Legislative Authority Timeline: This fact sheet provides a brief timeline of the budget and legislative action related to the ACC.

ACC Phase I Request for Proposals (RFP) from 2010: This is the full text of the RCCO RFP (ACC I Request for Proposals) released in 2010. It contains the foundation on which the ACC Program is based.

Fact Sheets and Policy Decisions

Framework for Behavioral Health Reimbursement: This document outlines the Department's framework for behavioral health reimbursement under Phase II.

Behavioral Health Reimbursement Program Decision: This documents updates the stakeholder on a change to the Department's proposal for reimbursing behavioral health services.

ACC Phase II Program Decision Reimbursement for Behavioral Health Services Presentation: Recorded presentation that provides an overview of ACC Phase II, behavioral health key concepts, the procurement timeline and how to stay informed.

April 2015 ACC Model Details and Policy Decisions: This document explains three key structural decisions that have been made for the ACC Model in the future: RCCO-BHO Administrative Structure, Regional Maps, and Payment.

Q and A from the ACC Model Details and Policy Decisions Document: This document responds to the questions we've received related to the April 2015 Model Details and Policy Decisions document.

Stakeholder Meeting Summaries

The list below includes meetings the ACC Phase II Team either hosted or presented at regarding the Phase II development.
 

December 2016
Stakeholder Engagement Webinar	Stakeholder Engagement Webinar Slides Recorded Stakeholder Engagement Webinar	December 15, 2016
CDPHE Medical Home Forum	Slide Presentation	December 13, 2016
Medical Services Board	Slide Presentation	December 9, 2016
Durango	Slide Presentation	December 3, 2016
Colorado Springs	Slide Presentation	December 1, 2016
Alamosa	Slide Presentation	December 1, 2016
November 2016
Fort Collins	Slide Presentation	November 30, 2016
State Medical Assistance and Services Advisory Council (NiteMAC) Meeting	Slide Presentation	November 30, 2016
Pueblo	Slide Presentation	November 30, 2016
Grand Junction	Slide Presentation	November 30, 2016
Stakeholder Engagement Webinar	Stakeholder Engagement Webinar Slides Recorded Stakeholder Engagement Webinar	November 29, 2016
Glenwood Springs	Slide Presentation	November 29, 2016
Burlington	Slide Presentation	November 29, 2016
Aurora	Slide Presentation	November 29, 2016
Stakeholder Engagement Webinar	Stakeholder Engagement Webinar Slides Recorded Stakeholder Engagement Webinar	November 21, 2016
Golden	Slide Presentation	November 18, 2016
Greeley	Slide Presentation	November 18, 2016
Longmont	Slide Presentation	November 17, 2016
ACC Program Improvement Advisory Committee (PIAC) Meeting	Slide Presentation	November 16, 2016
June 2016
ACC Client Perspective, COMMIT Presentation		June 15, 2016
Provider and Community Issues Subcommittee Meeting		June 9, 2016
May 2016
EPCM Review Findings, MMP Recommendations for Phase II RFP		May 18, 2016
Provider and Community Issues Subcommittee Meeting		May 12, 2016
April 2016
ACC Program Improvement Committee *		April 20, 2016
March 2016
March 2016 Behavioral Heath Transformation Council *		March 14, 2016
ACC Program Improvement Committee *		March 16, 2016
ACC Provider and Community Issues - ACC Program Improvement Committee Subcommittee Meeting		March 10, 2016
ACC: Medicare-Medicaid Program Subcommittee		March 3, 2016
February 2016
ACC Program Improvement Advisory Committee		February 17, 2016
January 2016
ACC Program Improvement Advisory Committee		January 20, 2016
December 2015
Presentation at All Kids Covered Meeting*		December 4, 2015
ACC Phase II Behavioral Health Community Meeting		December 7, 2015
Presentation at Disability Community Representatives / Department Meeting*		December 8, 2015
Colorado Medical Home Forum*		December 8, 2015
Presentation at Colorado Community Health Network Board Meeting*		December 9, 2015
ACC Provider and Community Issues - ACC Program Improvement Committee Subcommittee Meeting*		December 10, 2015
Presentation at Medical Services Board*		December 11, 2015
ACC Program Improvement Advisory Committee		December 16, 2015
November 2015
ACC: Medicare-Medicaid Program Subcommittee*		November 5, 2015
ACC Phase II Open Forum		November 10, 2015
ACC Provider and Community Issues - ACC Program Improvement Committee Subcommittee Meeting*		November 12, 2015
ACC Program Improvement Advisory Committee		November 18, 2015
Presentation at State Medical Assistance and Services Advisory Council Meeting*		November 18, 2015
Presentation at Alliance/State Forum Meeting*		November 19, 2015
Presentation at Colorado Health Institute's Safety Net Advisory Committee (SNAC) Lab*		November 19, 2015
October 2015
ACC Provider and Community Issues - ACC Program Improvement Committee Subcommittee Meeting*		October 8, 2015
ACC Program Improvement Advisory Committee		October 21, 2015
ACC Health Impact on Lives: Health Improvement - ACC Program Improvement Committee Subcommittee Meeting*		October 28, 2015
ACC: Medicare-Medicaid Program Learning Symposium*		October 29-30, 2015
September 2015
ACC Provider and Community Issues - ACC Program Improvement Committee Subcommittee Meeting*		September 10, 2015
ACC Program Improvement Advisory Committee		September 16, 2015
ACC Health Impact on Lives: Health Improvement - ACC Program Improvement Committee Subcommittee Meeting*		September 23, 2015
August 2015
ACC Program Improvement Advisory Committee		August 19, 2015
July 2015
Larimer County Meeting		July 8, 2015
Larimer County Meeting		July 9, 2015
Weld County Meeting		July 13, 2015
ACC Program Improvement Advisory Committee		July 15, 2015
Elbert County Meeting - Kiowa		July 15, 2015
June 2015
ACC Program Improvement Advisory Committee		June 17, 2015
May 2015
ACC Program Improvement Advisory Committee		May 20, 2015
April 2015
ACC Program Improvement Advisory Committee to discuss ACC Regional map and care coordination *		April 15, 2015
ACC Provider and Community Issues Subcommittee Meeting to discuss regional map *		April 16, 2015
March 2015
ACC Program Improvement Advisory Committee		March 18, 2015
January 2015
Preliminary findings from ACC Request for Information presented to ACC Program Improvement Committee		January 21, 2015
December 2015
ACC Program Improvement Advisory Committee		December 17, 2014
November 2014
ACC Program Improvement Advisory Committee		November 19, 2014
October 2014
Ongoing Stakeholder Engagement Strategy - Discussion at ACC Program Improvement Committee		October 15, 2014
September 2014
RFI Question Review - Discussion at ACC Program Improvement Committee		September 17, 2014
August 2014
Practice Support Requirements - Discussion at ACC Program Improvement Committee		August 20, 2014
July 2014
Care Coordination Requirements - Discussion at ACC Program Improvement Committee		July 16, 2014
June 2014
Meeting at RCCO 1 (Durango)		June 19, 2014
May 2014
Meeting at RCCO 3 and 5 (Denver)		May 6, 2014
Meeting at RCCO 1 (Fort Collins)		May 9, 2014
Meeting at RCCO 7 (Colorado Springs)		May 27, 2014
April 2014
Meeting at RCCO 1 (Glenwood Springs)		April 14, 2014
Meeting at RCCO 6 (St. Anthony's Hospital, Lakewood)		April 15, 2014
Strategy Session at ACC Program Improvement Committee		April 16, 2014
Meeting at RCCO 4 (Pueblo)		April 22, 2014
Meeting at RCCO 2 (Evans)		April 23, 2014

2014 Request for Information

The release of the ACC Request for Information (RFI) is one of the first steps to determine what the ACC will look like in the future.

RFIs are used to solicit advice and expertise from the public in advance of the creation of an RFP or a contract. Anyone is welcome to respond to an RFI, though oftentimes certain sections of an RFI are tailored to specific groups or entities - like providers, clients, or potential vendors. Alongside Colorado Health Institute (CHI), the Department has attended numerous public meetings across the state to hear stakeholders' concerns and aspirations. These conversations have helped to inform the RFI process.

The RCCO RFI was a "question-only" request for information. This means the RFI contained a series of targeted questions, rather than extensive draft contract language. This process has two advantages. First, it allows respondents greater latitude to focus on the areas they think are most important. Second, the information and perspectives shared by respondents are able to frame the conversation before specific contract requirements are formulated.

The RFI was released in late October 2014 and formal responses were due on November 24, 2014.

The RFI questions are available on Colorado BIDS and below.

• Executive Summary of ACC RFI
• Text of Responses to ACC RFI
• ACC Request for Information