Colorado

Colorado was an early adopter of the patient-centered medical home (PCMH) model of care delivery. In 2007, Colorado passed Chapter 346 which required the Colorado Department of Public Health and Environment (CDPHE) to increase the number of children served by medical homes. In 2009, Colorado launched one of the earliest multi-payer medical home pilots which ended in 2012 and resulted in many improvements both in costs and health outcomes.

In 2011, Colorado Medicaid launched the Accountable Care Collaborative with seven Regional Care Collaborative Organizations (RCCOs) to coordinate care statewide. Of these RCCOs, 18 are managed by community-based organizations that build on unique local strengths to address local needs.

Colorado continues to expand its health care reform efforts using a foundation of strong primary care and the integration of behavioral health. The CDPHE and the Colorado Department of Health Care Policy and Financing (HCPF) have jointly established the Colorado Medical Home Initiative to serve as a clearinghouse of information for the medical home approach in Colorado.

Primary Care Innovations and PCMH Activity

Dual Eligible	2703 SPA	CPC	CPC+	PCMH QHP	PCMH Legislation	Private Payer

Multi-Payer Programs

Program Name	Payer Type	Coverage Area	Parent Program
Colorado Comprehensive Primary Care Initiative	Multi-Payer	Statewide	CMS Comprehensive Primary Care Initiative
Colorado Comprehensive Primary Care Plus Initiative	Multi-Payer	Statewide	CMS Comprehensive Primary Care Plus (CPC+)
Colorado Multi-Payer Patient-Centered Medical Home Pilot	Multi-Payer	Statewide

Public Payer Programs

Program Name	Payer Type	Coverage Area	Parent Program
Advancing Care Together (ACT) Demonstration	Grant	11 demonstration sites located across the state
CMS State Innovation Model (SIM) Testing Award - Colorado	Grant	Statewide	CMS State Innovation Model (SIM)
Colorado Dual Eligible Demonstration	Medicare, Medicaid	Statewide	CMS Dual Eligible Demonstration
Colorado Medicaid Accountable Care Collaborative (ACC)	Medicaid	Statewide
Coordinating All Resources Effectively (CARE) - Colorado	Grant	California, Colorado, Florida, Missouri, Pennsylvania, Texas, Ohio	CMS Health Care Innovation Award (Round 2)
Integrated Ambulatory Care Project - Denver Health and Hospital Auhority	Grant	Denver	CMS Health Care Innovation Award (Round 1)
Medical Homes for Children Program	Medicaid	Statewide
School-Based Health Center Improvement Partnership (SHCIP) - Colorado	Grant	Colorado, New Mexico	CHIPRA Quality Demonstration Grant
Sustaining Healthcare Across Integrated Primary Care Efforts (SHAPE)	Other	Colorado Western Slope
The Colorado Family Medicine Residency Patient-Centered Medical Home Project	Grant	Denver, Fort Collins, Greeley, Pueblo, and Grand Junction

Private Payer Programs

Program Name	Payer Type	Coverage Area	Parent Program
Aetna Whole Health - Colorado	Commercial	Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, Jefferson, Larimer and Weld counties
Cigna Accountable Care Program - Boulder Community Hospital Community Medical Associates	Commercial	Boulder	Cigna Collaborative Care Program
Cigna Accountable Care Program - Colorado Springs Health Partners	Commercial	Colorado Springs	Cigna Collaborative Care Program
Cigna Accountable Care Program - New West Physicians P.C.	Commercial	Denver-area	Cigna Collaborative Care Program
Cigna Accountable Care Program - Physician Health Partners ACO	Commercial	Denver	Cigna Collaborative Care Program
Enhanced Personal Health Care Program - Colorado	Commercial	Statewide	Anthem - Enhanced Personal Health Care
Humana medical home program - Miramont Family Medicine	Commercial	Fort Collins	Humana Medical Home Program
UnitedHealthcare Patient-Centered Medical Home Program- Colorado	Commercial		UnitedHealthcare PCMH Program

State Legislation

Legislation	Status	Year
Chapter 346, Session Laws of Colorado 2007 This legislation defined "medical home" and required the Colorado Department of Public Health and Environment (CDPHE) to increase the number of children served by medical homes.	Enacted	2007
Colorado - HB18-1365 Primary Care Infrastructure Creation The bill establishes a primary care payment reform collaborative in the primary care office in the department of public health and environment. To facilitate the collaborative's work, the administrator of the all-payer health claims database is to report data on primary care spending by private health insurers, insurers providing state employee health benefit plans, and the department of health care policy and financing under the state medicaid program and the children's basic health plan.	Expired	2018
HB19-1233 Investments In Primary Care To Reduce Health Costs This bill establishes a primary care payment reform collaborative in the division of insurance in the department of regulatory agencies. It also requires the insurance commissioner to establish affordability standards for premiums, with added targets for carrier investments in primary care. Additionally, it requires the department of health care policy and financing and carriers who offer health benefit plans to state employees to set targets for investment in primary care.	Pending	2019
HB 19-1233 Tasks Insurance Commissioner with 1) forming a collaborative (the Colorado Primary Care Payment Reform Collaborative) to advise on increasing primary care spend 2) issue rules to set affordability standards, including PC spend targets	Enacted	2019