Alternative Payment Model 1 (APM 1)

The Alternative Payment Model for Primary Care (APM) is part of the Department's efforts to shift from paying for volume to paying for value across the entire delivery system. The APM is designed to support primary care providers through this shift. The Department, in close collaboration with stakeholders, has developed three goals for the APM:

Provide long-term, sustainable investments into primary care,
Reward performance and introduce accountability for outcomes and access to care while granting flexibility of choice to providers, and,
Align with other payment reforms across the delivery system.

Under the APM, the Department will adjust payments to primary care providers based on the providers' performance. Progress within this framework not only encourages higher organizational performance but also helps the Accountable Care Collaborative (ACC) achieve its programmatic goals. For an overview of the APM 1 program please watch the APM 101 Webinar

Who Can Participate?

Primary Care Medical Providers (PCMPs) who serve at least 500 attributed ACC enrollees are automatically enrolled in APM 1. Practices may petition HCPF to decline participation if they have insufficient data available to measure quality performance. PCMPs that have less than 500 attributed enrollees may also petition to participate in the program, if they have sufficient data available to measure quality performance. PCMPs who do not participate in APM 1 will not see a change in their reimbursement rates as a result of opting-out.

FQHCs are eligible to participate in APM 1. All FQHCs are automatically enrolled in the program

Program Resources

Quality Measures

Administrative Measure Specifications: Please view the 2023 Technical Specifications Resource Manual for administrative measure specifications, and the Value Set Directory for measure codes, as published by the Centers for Medicare and Medicaid Services. Note that to access the Technical Specifications Resource Manual, you must accept the license agreement.

eCQM Measure Specifications

Development History

HCPF convened a workgroup of primary care physicians, primary care practice coordinators, office managers, and other key stakeholders to design the APM in Fall 2016. This workgroup had input on almost every aspect of the APM, including quality measures and the payment structure. In collaboration with stakeholders, HCPF identified the following goals for the APM:

Provide long-term, sustainable investments in primary care;
Reward performance and introduce accountability for outcomes and access to care while granting flexibility of choice to PCMPs; and
Align with other payment reforms across the delivery system.

HCPF continues to conduct an annual stakeholder engagement process to inform updates to the model for each program year. This includes a series of public and workgroup meetings to solicit feedback on the APM such as updates to the measure set, point assignments, and goals for each measure as well as to ensure the APM model continues to achieve its goals.

To prepare for each program year, the Department engages a broad range of stakeholders to recommend changes and updates to the APM measure set, measure points, and measure goals. This stakeholder engagement process may include public listening sessions, ad hoc workgroup meetings, requests for written feedback, meetings with providers, and review by the ACC Program Improvement Advisory Committee (PIAC). Click on the link below to view stakeholder feedback and recommendations by program year.

The Department of Health Care Policy & Financing hosted three public listening sessions to provide updates on the APM program and solicit feedback from stakeholders to inform changes for 2024.

Stakeholder Engagement Meetings

2023 Program Resources

Quality Measures

^{Administrative Measure Specifications (formerly called Claims Measures)}

Comprehensive Diabetes Care: Hemoglobin (HbA1c) Testing
Lead Screening
For all other administrative measures, please visit the 2021 Technical Specifications Resource Manual for measure specifications, and the Value Set Directory for measure codes, as published by the Centers for Medicare and Medicaid Services. Note that to access the Technical Specifications Resource Manual, you must accept the license agreement.
Adult Measures
Child Measures

eCQM Measure Specifications

Contact Information

Email HCPF_primarycarepaymentreform@state.co.us for more information about the program.

Alternative Payment Model 1 (APM 1)