Primary Care Payment Reform Collaborative

House Bill 19-1233 established a Primary Care Payment Reform Collaborative (the Collaborative) led by the Colorado Division of Insurance (DOI).

*  * Currently Accepting New Members - Please Apply HERE  *  *

Created through House Bill 19-1233 and convened by the DOI, part of the Department of Regulatory Agencies (DORA), the Collaborative has been meeting since July of 2019 to develop recommendations aimed at increasing investments in high-quality primary care. The Collaborative focuses on developing strategies for increased investments in primary care that deliver the right care, in the right place, at the right time, and advises the DOI in the development of affordability standards and targets for health insurance company investments in primary care. The Collaborative further advances strategies that: 

• Reduce health care costs resulting in net savings;
• Are evidence-based and provide incentives for value rather than volume;
• Are adequate to sustain infrastructure to deliver advanced primary care that is patient-centered, comprehensive, coordinated, and accessible;
• Direct resources to the patient and practice level that expand the capacity of the primary care system to equitably meet the health needs of patients; and
• Sustain advanced primary care delivery models.

2025 Meeting Schedule for the Primary Care Payment Reform Collaborative

Until further notice, all Collaborative meeting will be REMOTE ONLY. Reasonable accommodation will be provided upon request for persons with disabilities. If you are a person with a disability who requires an accommodation to participate in a Collaborative meeting, please notify Tara Smith at 720-701-0081 or tara.smith@state.co.us at least one week prior to the meeting.  

Please register for upcoming meetings in 2025 using the following link: 

Register for 2025 Collaborative Meetings

July 2025 - SUMMER BREAK (NO MEETING)

Members please enjoy your summer break!

June 12, 2025

PCPRC Meeting Agenda - 6.12.25

PCPRC Slide deck - 6.12.25

People Demand Better Primary Care - Fact Sheet  - United States of Care, March 2025

Natalie Davis on Why You Shouldn't Talk about Value-Based Care - The ACO Show, 5.19.25

Strengthening Primary Care by Meeting People's Needs - Commonwealth Fund, 3.5.25

The General Public Vastly Overestimates Primary Care Spending in the United States - Annals of Family Medicine, March-April 2025

Letting Patients Lead the Way to More Effective Value-Based Payment - Health Affairs, 3.24.25

May 8, 2025

PCPRC Meeting Agenda - 5.8.25

PCPRC Slide deck - 5.8.25

PCPRC Meeting Minutes - 5.8.25

Reflecting on 2 Decades of Medicare ACO Experience - JAMA, 4.28.25**

Year 1 of Medicare’s Accountable Care Organization Realizing Equity, Access, and Community Health Model - JAMA, 4.25.25

The Value Zeitgeist - Considering the Slowdown in Health Care Spending Growth - NEJM, 4.17.25**

Changes in Primary Care Practice Setting and Practice Type for Medicare Beneficiaries - JAMA 4.25.25

“All I Do Is Win”: Why Beating Benchmarks Doesn’t Mean That ACOs Are Reducing Costs - Health Affairs, 4.15.25

April 10, 2025

PCPRC Meeting Agenda - 4.10.25

PCPRC Slide deck - 4.10.25

PCPRC Meeting Minutes - 4.10.25

Recent Events Have Made Primary Care More Fragile—Further Challenges Lie Ahead - Health Affairs, 3.4.25

From Laggard To Leader: Why Health Care In The United States Is Failing, And How To Fix It  - Health Affairs, 1.22.25**

The Health of US Primary Care: 2025 Scorecard Report — The Cost of Neglect - Milbank Memorial Fund, 2.18.25

Report from the Frontlines of US Primary Care on the Impact of Recent Federal Policy Changes - Milbank, 3.27.25

Can Prevention Save Money - JAMA Health Forum 4.3.25

March 13, 2025

*  *  Meeting Cancelled  *  *

February 6, 2025

PCPRC Meeting Agenda - 2.6.25

PCPRC Slide deck - 2.6.25

PCPRC Sixth Annual Recommendations Report - DRAFT 3 - 1.27.25

January 9, 2025

PCPRC Meeting Agenda - 1.9.25

PCPRC Slide Deck - 1.9.25

PCPRC Meeting Minutes - 1.9.25

PCPRC Sixth Annual Recommendations Report - DRAFT 2 - 1.3.25

In addition to focusing on the development of strategies for increased investments in primary care leading to delivery of the right care in the right place at the right time, the Collaborative also works with various groups and organizations, while developing other recommendations and reports regarding primary care. At a high level, the Collaborative engages in the following:

• Consult with the Department of Personnel, the Department of Health Care Policy and Financing (HCPF), and the Colorado All-Payer Claims Database (APCD);
• Advise in the development of broad based affordability standards and targets for carrier investments in primary care;
• Coordinate with the APCD to analyze the percentage of medical expenses allocated to primary care by insurers, Health First Colorado (Colorado’s Medicaid Program), Children’s Health Plan Plus (CHP+);
• Develop a recommendation to the Insurance Commissioner on the definition of primary care for these purposes;
• Report on current health insurer practices and methods of reimbursement that direct greater health care resources and investments toward health care innovation and care improvement in primary care;

• Identify barriers to the adoption of alternative payment models by health insurers and providers and develop recommendations to address these barriers;
• Develop recommendations to increase the use of alternative payment models that are not fee-for-service in order to:
  • Increase investment in advanced primary care delivered by practices that are Patient Centered Medical Homes or practices that have demonstrated ability to provide high-quality primary care;
  • Align primary care reimbursement by all consumers;
  • Direct investment toward higher-value primary care services with an aim at reducing health disparities;
• Consider how to increase investment in advanced primary care without increasing costs to consumers or increasing the total cost of health care; and
• Develop and share best practices and technical assistance to health insurers and consumers.

Participants in the Collaborative are asked to commit 4-6 hours per month. Additional information regarding the Collaborative's administrative operations are outlined in the Primary Care Payment Reform Collaborative's Standard Operating Procedures and Rules of Order.

Current Collaborative Members

Polly Anderson - Health Care Provider, Denver Metro Area

Josh Benn - Colorado Department of Personnel and Administration

Erin McCreary - Health Care Consumer, Colorado Springs

Britta Fuglevand - Colorado Department of Health Care Policy & Financing

Patrick Gordon - Health Insurer Representative, Western Slope

John Hannigan - Acting Regional Director, Region VIII, U.S. Department of Health and Human Services

Steve Holloway - Colorado Department of Public Health & Environment

Lauren Hughes - Health Care Provider, Denver Metro Area

Alexandra Hulst - Health Care Provider, Western Slope

Rajendra Kadari - Health Care Provider, Denver Metro Area

Cassana Littler - Primary Care Provider, Denver Metro Area

Amanda Massey - Health Insurer, Denver Metro Area

Kevin McFatridge - Health Insurer, Denver Metro Area

Dana Pepper - Health Insurer, Denver Metro Area

Amy Scanlan - Health Care Provider, Denver Metro Area

Mannat Singh - Health Care Consumer, Denver Metro Area

Gretchen Stasica - Health Insurer, Denver Metro Area

Kevin Stansbury - Health Care Provider, Eastern Slope

Jack Teter - Health Care Provider, Denver Metro Area

For more information about the Collaborative, contact Tara Smith, Primary Care and Affordability Director - tara.smith@state.co.us; 720-701-0081.