Skip to main content

We Have Liftoff: Medicaid Launches Next Phase of Reform Effort

Chef Boyardee would be proud.

Colorado’s Medicaid program — known as Health First Colorado — is an alphabet soup of acronyms: HCPF, ACC, PMPM, RCCO, BHO, FFS, CMHCs, APM, PIAC. And that’s just Medicaid. Don’t forget CHP+, LTSS and CICP.*

Yesterday, July 1, 2018, a new acronym officially entered our lexicon. Health First Colorado launched the Regional Accountable Entities, or RAEs, as part of the next chapter in Colorado’s Medicaid program.

The RAEs are companies with which the Colorado Department of Health Care Policy and Financing (HCPF) is contracting to manage Health First Colorado regionally. The seven regions are displayed in the map below. (Two of the RAEs manage two regions each.)

A Map shows the regions covered by Colorado's new Medicaid reform effort

This month’s launch of the RAEs marked the culmination of planning efforts over the past few years by HCPF and stakeholders.

HCPF is transitioning to the next iteration of the Accountable Care Collaborative (ACC), Colorado’s big push to reform Medicaid. The ACC aims to connect the state’s 1.3 million Medicaid members to primary care, coordinate their services across providers and ensure timely access to behavioral health care. The hope is that the ACC will increase the quality and efficiency of care so that Medicaid members’ health improves while costs to the state decrease.  

That’s where the RAEs come in. The RAEs replace two mainstays of Phase One of the ACC: the Regional Care Collaborative Organizations (RCCOs) — which largely focused on primary care — and the Behavioral Health Organizations (BHO), which managed mental health services. In Phase Two of the ACC, the RAEs will take over the duties performed by both the RCCOs and BHOs. In a nutshell, RAEs are now responsible for building networks of primary care and behavioral health providers, providing care coordination services and monitoring progress toward goals. Phase Two also introduces a variety of financial incentives to encourage RAEs and providers to meet their goals.

CHI explores the role of RAEs in its publication The Route to the RAEs.

The big question is whether the iterative approach of the ACC will result in greater savings and better outcomes. The results to date have been small but encouraging: The latest report to the state legislature reported a net of $21.6 million of costs avoided in FY 2016-17 due to the ACC. This is a drop in the bucket of HCPF’s total $10 billion budget, but it’s a step in the right direction. The report also cites improvements in well-child visits, postpartum care and decreased emergency room use among Medicaid members.

Almost one fourth of Coloradans are covered by Medicaid, and the CHI team is committed to monitoring the rollout of Phase Two of this reform effort throughout the next year and beyond. A sneak peek at CHI’s upcoming suite of information to help you make sense of the changes:

  • A companion piece to The Route to the RAES that profiles the RAEs: what they are, who operates them, their responsibilities and role in payment to providers.
  • Our inaugural series of podcasts in which we interview HCPF and RAE leaders and gain their insights into the ACC’s potential and its challenges.
  • An interactive map on CHI’s website that highlights facts about each RAE region.
  • Further exploration of hot topics in Phase Two, including a new and highly anticipated provision to primary care providers for up to six visits of behavioral health services.

Stay tuned for further developments in the wide world of Medicaid (and its many acronyms, BTW ICYMI LOL).

* Curious about these acronyms? Download CHI’s popular HealthWords glossary as a quick reference to the alphabet soup. 

Want more information about health and health policy in Colorado? Subscribe to our newsletter or find CHI on Facebook and Twitter

Related Blogs and Research