New Structures for Colorado’s Medicaid Program; New Podcast for CHI

Nearly 1.3 million Coloradans get their health insurance through Health First Colorado, the state’s Medicaid program. That means changes to the program have an outsized impact on health and health care systems in the state.

This July brought with it a change that will affect the shape of Medicaid for years to come. Health First Colorado launched the next phase of its ongoing reform initiative, the Accountable Care Collaborative (ACC), an effort to reduce costs and improve care.  

The ACC Phase Two has several components, many of them aimed at streamlining how physical health care and behavioral health care are delivered and administered. For instance, for the first time, all Medicaid members, except those in the Program for All-Inclusive Care for the Elderly (PACE), are enrolled in the ACC. And also for the first time, primary care physicians can bill for six behavioral health visits.

Perhaps the biggest change was the introduction of new regional organizations called Regional Accountable Entities. RAEs manage both physical and behavioral health care in seven regions around the state. They replace Regional Care Collaborative Organizations (RCCOs), which were responsible for managing primary care, and Behavioral Health Organizations (BHOs), which previously connected members to behavioral health care.

The Colorado Department of Health Care Policy and Financing (HCPF) selected five organizations to serve as RAEs and developed several financial incentives for reaching certain “key performance indicators,” such as reducing the number of emergency room visits.

So, what exactly does a RAE do, why does this change matter, and what questions should we be thinking about as this new chapter in the Medicaid program rolls out? That’s what CHI wanted to explore in our newest publication, The Ways of the RAEs. 

In it, we review the history that brought us to the ACC Phase Two; explain changes to payment systems that come along with it; and pose some questions as the RAEs move forward.

We interviewed leaders from each RAE to learn more about what makes their region distinct and how each RAE is thinking about health and health care.

You’ll also find something new from CHI — a podcast called The Checkup.

The Checkup’s inaugural episodes features an interview with a RAE leader. We also interviewed Laurel Karabatsos, who’s overseeing this initiative at HCPF.

The episodes were recorded in the months leading up to and immediately following the launch of RAEs. We had fascinating conversations about topics like housing and health, regional differences in health, and how the RAEs are thinking about integrating health care.

So check out our paper and podcasts. And stay tuned for in-depth looks at the ACC Phase Two – and more podcasts on other subjects in health policy.

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Related Blogs and Research

• We Have Liftoff: Medicaid Launches Next Phase of Reform Effort
• Medicaid's Road to Change
• Managing Medicaid in Colorado
• Colorado Medicaid Enrollment Drops After Years of Growth
• Route to the RAEs