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Accountable Care Collaborative
Phase II Update
February 5, 2016                                                                                       
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February ACC Phase II Update

The Department of Health Care Policy and Financing (Department) is working with our partners to develop the next phase of the Accountable Care Collaborative (ACC). Phase II of the ACC seeks to leverage the proven successes of Colorado Medicaid's programs to enhance the Medicaid client and provider experience. Learn more about ACC Phase II.

The Department has received tremendous response from the community regarding the next Phase of the ACC. Generally feedback has been positive but stakeholders have raised concerns regarding the timeline of the procurement and the proposed payment methodology for behavioral health services.
 
In this issue you will find:
  1. Department announcement regarding the ACC Phase II procurement timeline
  2. Department announcement regarding behavioral health services reimbursement methodology
  3. Information on how stakeholders can stay informed
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ACC Phase II Procurement Timeline
In response to feedback from the community and evolving guidance from the Centers for Medicare & Medicaid Services (CMS), the Department has decided to adjust the procurement timeline for Phase II of the ACC and begin the next phase on July 1, 2018.
 
The Department weighed numerous internal and external factors when considering the revision of the ACC Phase II procurement timeline. From the outset, the Department was aware that the original proposed timeline was aggressive given the time required to support a transparent procurement process, identify and receive the appropriate federal authority to implement the program, and incorporate stakeholder feedback. 

By extending the timeline, the Department will be able to:
  • Allow for adequate time to engage our partners across the state and review feedback.
  • Drive performance and stage innovations within the existing contracts to prepare providers and the community for an increased focus on value-based payments as part of Phase II.
  • Consider and anticipate future impacts of budget decisions, rules, and regulations, and ensure alignment with evolving federal payment reform guidance.
  • Further gain a better understanding of the waiver(s) and State Plan Amendments that may be needed to implement the proposed Phase II concepts through ongoing conversations with CMS.

The Department is committed to continuing delivery system innovation as we work towards Phase II. Over the next two years, the Department will work with our providers and the current Regional Care Collaborative Organizations (RCCOs) and Behavioral Health Organization (BHOs) to innovate and transform our delivery system, including further implementation of:
  • Cost savings measures,
  • Financial transparency,
  • Pay for performance and alternative payment methodologies (i.e., bundles of services and payments),
  • Integrated care,
  • Learnings from projects and pilots including the State Innovation Model (SIM), Comprehensive Primary Care Initiative (CPCI), 1281 Payment Reform Pilots, and Medicare Access & CHIP Reauthorization Act (MACRA),
  • Local public health agency partnerships, and
  • Systems to support innovation.
The Department is confident these ongoing innovations and the revised procurement timeline will help better meet the needs of our community.
Behavioral Health Services Payment Methodology
The Department has revised its proposal for reimbursing behavioral health services as outlined in the ACC Phase II Concept Paper. A modified capitation payment methodology will be retained for core behavioral health services. The capitation will be directed to the Regional Accountable Entities who will be responsible for managing the health needs of Medicaid enrollees in their region. The capitation will differ from the current capitation administered by the Behavioral Health Organizations (BHOs) in order to better support whole person accountability. Differences include:
  • Adjustments to the diagnosis and services parameters to help clients access behavioral health services and reduce barriers to care,
  • New value-based purchasing incentives (both monetary and measurement) that promote accountability for physical and behavioral health outcomes, and
  • Shifts in funding to create flexibility to pay for integrated behavioral health services within primary care settings.
For more information about this proposal change, check out our ACC Phase II Program Decision: Reimbursement for Behavioral Health Services fact sheet.

The Department will continue engaging stakeholders to define the program changes, including identifying the core behavioral health services that will be paid through the capitation.
Opportunities for Engagement & Staying Informed
The Department will host a webinar on Tuesday, Feb. 9 from 2:00-2:45pm. We will use this time to give a brief overview of the Phase II timeline and the behavioral health services reimbursement program decision, as well as provide attendees an opportunity to ask questions. Please use the information below to join the webinar:

Call in number: 1-877-820-7831; Participant code: 423066#
 
The ACC Phase II Team will continue to utilize the currently scheduled   ACC Program Improvement and Advisory Committee (PIAC) and Subcommittees to solicit feedback. These meetings are open to the public and have a call in option for participation. Notes will be available online following the meetings.
 
We encourage all interested parties to sign up for the ACC Phase II Stakeholder Updates list . The Department will use this list and our site, Colorado.gov/HCPF/ACCPhase2 , as the primary vehicles to announce feedback opportunities and Phase II developments. 
Colorado Dept. of Health Care Policy & Financing  
(303) 866-2993 | 1570 Grant Street, Denver, CO 80203