Accountable Care Collaborative |The Department of Health Care Policy and Financing announced that the Department reduced Medicaid health expenditures by $20 million with its Accountable Care Collaborative (ACC) program, and returned nearly $3 million to state and federal taxpayers. This is the first year of the Accountable Care Collaborative program which is designed to improve client health while lowering health costs. The Department brought the program to state lawmakers as a budget reduction item in 2009 with the expectation the program would not only pay for itself, but reduce taxpayer dollars in the future.
“We’re very pleased with the results and how the program is developing,” said Laurel Karabatsos, deputy Medicaid director. “We believed we were making the right estimates to begin with, and we’re very pleased that everything is pointing in the right direction.”
Community Health Partnership, a coalition of local health care providers, operates Community Care of Central Colorado, the Accountable Care Collaborative for Region 7 (El Paso, Elbert, Park, and Teller Counties).
In the ACC’s first year, the Department identified three key performance indicators to measure improvement among those clients enrolled in the Accountable Care Collaborative, compared to clients not yet enrolled.
Hospital Readmissions…there was an 8.6% reduction in readmissions among Accountable Care Collaborative clients statewide. Locally, Region 7 had a reduction of 30% in hospital readmissions and a 4.5% reduction when adjusted for the acuity of enrollees. Emergency Room Utilization…Overall, statewide there was a 1% increase among Medicaid clients, but only a .23% increase among Accountable Care Collaborative enrollees. Region 7 experienced an increase in overall emergency department (ED) utilization as well, and it has been noted that 23% of Region 7 ED visits are actually Urgent Care visits that were billed through a hospital and therefore counted as ED visits. This is a unique issue for our region and is being reviewed to determine how this has impacted the utilization data. Care Coordination efforts focus on monitoring the top ED utilizers in Region 7 (individuals with ED visit in the past year without an admission to the hospital). This group showed more than approximately 50% improvement in ED utilization with case management efforts. High Cost Imaging…3.3% decrease among Accountable Care Collaborative clients statewide. Region 7 also experienced a 3% decrease in high cost imaging with a 4.2% decrease when adjusted for the acuity of the enrollees.
Executive Director Sue Birch believes when more clients are enrolled, the Department will continue to see positive outcomes. “These early results support our belief the interventions we’re doing are working, and with more time to increase Accountable Care Collaborative enrollment, we expect to have greater impact,” she said.
The Accountable Care Collaborative program has approximately 132,000 Medicaid clients enrolled throughout Colorado, which represents about 21% of the total Medicaid population (current Region 7 enrollment is 33,486 through October 31, 2012). Going forward Birch says, “We really hope to be able to expand and look at how we can integrate care, improve health outcomes, and ultimately be a healthier Colorado. We anticipate there will be more savings as we enroll more clients into the Accountable Care Collaborative where their care can be better coordinated.”