Current Updates (as of 8/3/2021)
Medicaid Medicare Integration
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On July 7, 2021, the Centers for Medicare & Medicaid Services (CMS) published a report on the Medicare savings estimates for Colorado’s managed fee-for-service (MFFS) demonstration for Demonstration Years 2 and 3. The demonstration, named the Accountable Care Collaborative: Medicare-Medicaid Program (ACC:MMP) took place in Colorado from September 1, 2014 to December 31, 2017. The demonstration sought to coordinate medical care, behavioral health services, and long-term services and supports for individuals dually eligible for both Medicare and Medicaid. This report is the third Medicare savings report for the demonstration and includes calculations on the final Medicare costs for Demonstration Year 2 and preliminary savings for Demonstration Year 2. (Source: Demonstration Year 2 Final and Demonstration Year 3 Preliminary Medicare Cost Savings Report for Colorado MFFS Demonstration; 7-7-2021) |
Past Updates
Accountable Care Collaborative
In June 2012, the governor signed a bipartisan bill establishing an Accountable Care Collaborative (ACC) to pilot-test Medicaid fee-for-service alternatives and Regional Care Collaborative Organizations (RCCOs). (Source: ModernHealthcare.com; ModernPhysician.com) Medicaid clients in the ACC will not only receive regular Medicaid benefits but also belong to an RCCO that will connect them with Medicaid providers and assist them with care transitions. All clients enrolled in the ACC will be required to choose a Primary Care Medical Provider as their medical home. (Source: State RCCO website; State Accountable Care Collaborative website)
CMS selected Colorado to participate in its Comprehensive Primary Care (CPC) Initiative, which Colorado implements through its existing ACC Program. The CPC Initiative strengthens primary care and fosters collaboration between health care systems. (Source: Colorado Department of Health Care Policy and Financing; CMS Comprehensive Primary Care Initiative website)
On October 21, 2014, the Colorado Department of Health Care Policy and Financing (DHCPF) issued a Request for Information (RFI) seeking stakeholder input and feedback on the future of the Accountable Care Collaborative (ACC). Input received during this RFI will help the DHCPF design what the ACC will look like in the future through the upcoming Request for Proposals (RFP) process for each Regional Care Collaborative Organization (RCCO). Responses to the RFI are due by November 24, 2014. (Source: Colorado DHCPF website)
ACC Request for Information (10/21/2014)
State Demonstration to Integrate Care for Dual Eligible Individuals
The Colorado Demonstration to Integrate Care for Medicare-Medicaid Enrollees builds on the infrastructure, resources and provider network found in the Accountable Care Collaborative (ACC) Program. The initiative will include the state’s entire dually-eligible population, including its I/DD populations, in its managed fee-for-service duals demonstration. (Source: NASDDDS Managed Care Tracking Report) The demonstration will enhance coordination between acute and long-term care. Covered benefits will include: Medicare Parts A, B, and D; the Medicaid State Plan; Behavioral Health Services available under an existing §1915(b) Medicaid waiver; and Home and Community-Based Services available under §1915(c) Medicaid waivers. Colorado did not specify the proposed demonstration implementation date. (Source: Demonstration Proposal; State Duals Demonstration website)
On February 28, 2014, CMS and the state signed a Memorandum of Understanding for the state’s managed fee-for-service demonstration model. (Source: CMS Demonstration Approvals website; CMS website; NSCLC Dual Eligible State Profiles website, 4/2014; Kaiser Family Foundation Duals Demonstration Proposal Status Map (4/2014) Memorandum of Understanding (2/28/2014)
On June 18, 2014, the state announced it received a $13.6 million grant from CMS to implement its duals demonstration; the grant will aid the state in implementing the ACC program to coordinate care for more than 50,000 dual eligibles. (Source: HMA Weekly Roundup, 6/18/2014)
On July 16, 2014, Colorado and CMS signed a managed fee-for-service Financial Demonstration Agreement, establishing the terms and conditions for implementing the Colorado Demonstration to Integrate Care for
Medicare-Medicaid Enrollees. The state will implement its demonstration on September 1, 2014. (Source: CMS Colorado Demonstration website) The state will implement its duals demonstration on September 1, 2014. The program will integrate and coordinate physical, behavioral, and social health needs for full-benefit Medicare-Medicaid clients. Full benefit dual enrollees not already participating in an integrated system of care will be passively enrolled in the program with an option to opt-out. (Source: HMA Weekly Roundup, 8/6/2014)
Financial Demonstration Agreement (7/16/2014)
On September 1, 2014, the state began enrolling full benefit Medicare and Medicaid clients into the Accountable Care Collaborative (ACC): Medicare-Medicaid Program; and the state will continue to phase in enrollment over the next seven months. Full benefit Medicare-Medicaid enrollees that are not already participating in an integrated system of care will be passively enrolled in the program with an opt-out option. Clients have the right to keep all their current benefits and use the same doctors. (Source: HMA Weekly Roundup, 9/3/2014)
On November 19, 2014, CMS posted the Evaluation Design Plan for Colorado’s duals demonstration. (Source: CMS website)
Colorado Evaluation Design Plan (10/30/2014)
On October 23, 2017, the Centers for Medicare & Medicaid Services (CMS) posted Colorado’s Transition and Phase Out Plan for the state’s managed FFS financial alignment demonstration, which expires December 31, 2017. The state intends to transition enrollees into its broader Accountable Care Collaborative (ACC) initiative, and will seek to take away promising practices from the demonstration and apply them to the ACC delivery system. (Source: CMS.gov 10/23/2017; Transition and Phase-Out Plan)
CMS released a preliminary savings report for the Colorado Managed Fee-for-Service (MFFS) demonstration project. The report contains the gross Medicare savings calculation results for Demonstration Period 1 and 2. The gross Medicare savings were determined by comparing expenditure growth rates and other states, specifically per member per month costs, between Colorado. The demonstration was meant to coordinate long-term services and supports, medical care, and behavioral health services for individuals enrolled in the Accountable Care Collaborative: Medicare-Medicaid Program (ACC:MMP). The demonstration was implemented in September 2014 and ended December 2017.
This report was published in January 2019 and announced the CMS website in May 24, 2019.
(Source: Preliminary Savings Report for Colorado MFFS Demonstration Period 2; January 2019)
Section 1915(i) HCBS State Plan Option
As of May 2014, CMS has approved the state’s §1915(i) HCBS State Plan Amendment; and the state is currently participating in the HCBS State Plan Option. (Source: Kaiser HCBS State Plan Option website, 5/2014)
Section 1915(k) Community First Choice Option
The state is considering the Community First Choice Option. In 2012, Colorado's LTSS Strategic Planning Report identified CFC as an important LTSS initiative; and the state formed a CFC Council. (Source: Colorado CFC website; LTSS Strategic Planning Report)
In May 2014, Colorado’s Department of Health Care Policy and Financing held a CFC Council meeting, during which the Council stated its intent to continue moving CFC forward, as well as the need for additional funding to move CFC forward. (Source: CFC Council Minutes, 5/5/2014; Colorado CFC website)