House Committee on Health, Insurance & Environment (03/12/2013)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH, INSURANCE & ENVIRONMENT

Date:	03/12/2013	ATTENDANCE

Time:	01:34 PM to 02:26 PM	Conti
		Fields
Place:	HCR 0107	Ginal
		Humphrey
This Meeting was called to order by		Joshi
	Representative Primavera	Primavera
		Stephens
This Report was prepared by		Swalm
	Elizabeth Burger	Young
		Schafer
		McCann
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
Presentation on ACC and RCCOs		Witness Testimony and/or Committee Discussion Only

01:34 PM -- Presentation on the Accountable Care Collaborative (ACC) and Regional Care Coordination Organizations (RCCOs)

Representative Primavara called the Joint House Health, Insurance, and Environment and Public Health Care and Human Services Committee to order. Gretchen McGinnis, Colorado Access, began an overview of the Accountable Care Collaborative (ACC) and Regional Care Coordination Organizations (RCCOs). A handout was distributed to the committee (Attachment A). She noted that there are three components to the ACC: 1) a statewide data and analytics contractor which provides RCCOs and primary care providers with data; 2) Primary Care Medical Providers (PCMPs), who are primary care providers that participate in RCCOs and who must complete additional contracts to participate in the ACC; and 3) the RCCOs. She noted there are seven RCCO regions in the state, and five contractors for the seven regions. She stated that the panel of presenters contains representatives from each RCCO. Each RCCO has a different approach, but each is focused on three primary performance indicators: 1) reduction in emergency room visits; 2) reduction in hospital readmissions within 30 days of discharge; and 3) reduction in high-cost imaging services. She noted that total cost of care is also a metric for RCCOs. She stated that about 30 percent of Medicaid clients statewide are enrolled in a RCCO and noted that the RCCO is responsible for connecting clients with a medical home. She described the payment structure for PCMPs and RCCOs in the ACC. She noted that the Department of Health Care Policy and Financing is now paying providers and RCCOs for outcomes and that a bill passed in the previous session allows for different payment reform models to align payments with provider incentives within the ACC.

130312 AttachA.pdf

01:41 PM

Donna Mills, Integrated Community Health Partners, gave an example of a client served by the RCCO in Southeast Colorado. She described the coordination of care that has occurred to connect the client to behavioral and physical health care and alcohol and drug abuse treatment.

01:46 PM

Dr. Ryan Ward, Physician Health Partners and Colorado Community Health Alliance, described the RCCO in West Denver and noted that the RCCO is a collaboration between Centura Health, Primary Physician Partners, and Physician Health Partners. He described patient-centered medical homes and stated that medical homes are essential to delivering high-quality health care. He gave an example of how a medical home can serve a high-cost Medicaid client. He noted that there is national interest in the ACC and stated the Colorado is leading the states in innovation and integration of physical and mental health care.

01:52 PM

Joel Dickerman, Community Care of Central Colorado, testified that local involvement and allowing physicians to be part of the solution have been successful components of the ACC. He spoke about the process through which RCCOs obtain and share data, which he stated allows for process improvement and waste reduction. He noted that there is money available for pilot projects, which further allow for innovation. He stated that the ACC allocates money to RCCOs based on the severity of patients' needs, which prevents cherry-picking of healthy patients.

01:56 PM

Patrick Gordon, Rocky Mountain Health Plans, discussed the RCCO Region 1 and stated that the RCCO program aligns with the values of the local area served by Rocky Mountain Health Plans. He stated that public health services are also being integrated into RCCOs. He said that moving ahead, focus needs to be placed on data sharing and payment reform.

02:02 PM

Mr. Dickerman responded to questions from Representative Primavera regarding reducing expenses associated with high-cost Medicaid clients and keeping clients in their homes as long as possible. Dr. Ward responded to questions from Representative Stephens regarding the accessibility of data for providers participating in the ACC. He discussed the challenges involved with getting the physicians to use the data for process improvement and the importance of obtaining real-time data. The committee and panel continued to discuss the availability of real-time data and data sharing. Mr. Dickerman responded to questions regarding incentives for physician participation in RCCOs. Representative Schafer asked how patients get connected to a RCCO, and Ms. McGinnis noted that the goal is to, over time, enroll all Medicaid patients in a RCCO.

02:22 PM

Ms. McGinnis discussed the payment of physicians in the ACC and explained how cost savings are obtained. She noted that cost savings are expected to increase over time.

02:26 PM

The committee adjourned.