House Bill 19-1233 established a Primary Care Payment Reform Collaborative (the Collaborative) to be led by the Colorado Division of Insurance (DOI).
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 advise in the development of affordability standards and targets for carrier investments in primary care.
Second Annual Recommendations Report - DECEMBER 2020 - Primary Care Payment Reform Collaborative
First Annual Recommendations Report (Dec 2019) - Primary Care Payment Reform Collaborative
The Collaborative, created through HB19-1233 and convened by the Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), has been meeting since July of 2019 to develop recommendations aimed at increasing investments in high-quality primary care. Increased investment can lead to better access, and access to primary care is a key part of our health care system.
2021 Meetings
2021 Meeting Calendar for Primary Care Payment Reform Collaborative
Until further notice, all Collaborative meetings will be REMOTE ONLY - you can register for all upcoming meetings using the following link:
https://attendee.gotowebinar.
- May 13, 2021
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Agenda coming soon
- April 13, 2021
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CPC+ Practice Care Delivery Requirements
MPC Framework for Whole Person Care
- March 8, 2021
- Feb 9, 2021
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PCPRC Standard Operating Procedures and Rules of Order - Rev Feb 2021 - DRAFT
- Jan 19, 2021
2020 Meetings
- Dec 7, 2020
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Please register for the webinar using the following link: https://attendee.gotowebinar.com/register/1698928392429903632
- Nov 19, 2020
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Please register for the webinar using the following link: https://attendee.gotowebinar.com/register/7073643594696597264
Report of Colorado Primary Care Spending and Alternative Payment Model Use, 2017-2019 - Center for Improving Value in Health Care
- Nov 2, 2020
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Please register for the webinar using the following link: https://attendee.gotowebinar.com/register/5919404875159405072
- Oct 13, 2020
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Please register for the webinar using the following link: https://attendee.gotowebinar.com/register/1121969561359161872
- Sept 21, 2020
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Please register for the webinar using the following link: https://attendee.gotowebinar.com/register/711116150637346832
- Sept. 1, 2020
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Please register for the webinar using the following link: https://attendee.gotowebinar.com/register/3809323313919091472
Supporting the Critical Role of Primary Care in the COVID-19 Response - Commonwealth, August 18, 2020
After COVID-19, A Payment Policy Reboot: Three Lessons From The Pandemic On How To Improve Value-Based Payment - Health Affairs, August 11, 2020
COVID-19, Market Consolidation, And Price Growth - Health Affairs, August 3, 2020
The Day After Tomorrow Must Include Independent Primary Care - Health Affairs, July 23, 2020
- August 10, 2020
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Please register for the webinar using the following link: https://attendee.gotowebinar.com/register/6283685171786849291
DRAFT New Regulation 4-2-7X - Concerning Strategies to Enhance Health Insurance Affordability
Overview of Revised PC-AMP Regulation
- July 7, 2020
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Webinar: https://meetingsamer.webex.com/meetingsamer/j.php?MTID=m0d2134a15a8bd6848d39183a30526333; By phone: 1-408-418-9388; Access code: 126 394 2262; Password: PCPRC
Primary Care Payment Reform Collaborative Telehealth Recommendations - Final Draft for Approval
- June 11, 2020
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Webinar: https://meetingsamer.webex.com/meetingsamer/j.php?MTID=mab788fb572ae9c9a32545c3f0e9eb173; By phone: 1-408-418-9388; Access code: 126 623 1468; Password: PCPRC
- May 18, 2020
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Webinar: https://meetingsamer.webex.com/meetingsamer/j.php?MTID=me7987339eb2a395fd8ea7256f54149ec; By phone: 1-408-418-9388; Access code: 625 923 786; Password: PCPRC
Primary Care in CO - COVID-19 and Beyond
How Payment Reform Could Enable Primary Care to Respond to COVID-19 - Updated Milbank Brief, May 2020
Telemedicine in Colorado: The Jetsons, a RAPID Response to COVID-19, and the Big Questions Ahead - Colorado Health Institute Report
Populations at Risk for Serious Illness from COVID-19 - CIVHC analysis
Standard Operating Procedures and Rules of Order - UPDATED 5.18.20
- April 29, 2020
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Webinar: https://meetingsamer.webex.com/meetingsamer/j.php?MTID=m44e3db5e1dd51f6012d6c3eea52d5029; By phone: 1-408-418-9388; Access code: 626 828 694
Draft PCPRC Project/Annual Report Planning Tool
Milbank Issue Brief, April 2020- How Payment Reform Could Enable Primary Care to Respond to COVID-19
Health Affairs article, April 17, 2020- The COVID-19 Tsunami: The Tide Goes Out Before It Comes In
- March 17, 2020
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1560 Broadway, Room 110B, Denver 80202, Dial-in: 720-279-0026, Passcode: 197413
- Feb. 27, 2020
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1560 Broadway, Room 110B, Denver 80202, Dial-in: 720-279-0026, Passcode: 197413
HCPLAN Alternative Payment Models (APM) Framework
PCPRC Statement from Co-Chair Nominees
DRAFT Regulation 4-2-7X Concerning Strategies to Enhance Health Insurance Affordability
- Feb. 3, 2020
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1560 Broadway, Room 110B, Denver 80202, Dial-in: 720-279-0026, Passcode: 197413
Primary Care Investment - Potential Metrics
- Jan. 14, 2020
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1560 Broadway, Room 100 C, Denver 80202, Dial-in: 720-279-0026, Passcode: 197413
CIVHC Data Submission Guide - DRAFT Letter
PCPRC Process Recommendations for 2020
Colorado PCPRC Standard Operating Procedures and Rules of Order
2019 Meetings
- Dec. 12, 2019
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1560 Broadway, Room 110D, Denver 80202, Dial-in: 720-279-0026, Passcode: 197413
PCPRC Recommendations Report - Final Version for PCPRC Review
- Dec. 2 2019
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1560 Broadway, Room 110D, Denver 80202, Dial-in: 720-279-0026, Passcode: 197413
Draft PCPRC Report Review Matrix
Colorado PCPRC Recommendations Report for Dec. 15, 2019 - DRAFT
Colorado PCPRC Standard Operative Procedures and Rules of Order - FINAL
- Nov. 12, 2019
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Colorado Health Institute, 303 E. 17th Avenue, Suite 930, Denver; Dial-in: 720-279-0026, Passcode: 197413
- Oct. 22, 2019
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1560 Broadway, Room 110D, Denver 80202; Dial-in: 720-279-0026, Passcode: 197413
Primary Care Investment - National and State Analyses
Primary Care Investment Targets - Other States
Primary Care Spending in the Fee-for-Service Medicare Population
Standardizing the Measurement of Commercial Health Plan Primary Care Spending
- Sept. 30, 2019
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1560 Broadway, Room 110D, Denver 80202; Dial-in: 720-279-0026, Passcode: 197413
Investing in Primary Care: A state-level analysis (July 2019) - from the Patient-Centered Primary Care Collaborative
2019 Colorado Health Access Survey (CHAS): Progress in Peril - from the Colorado Health Institute
- Sept. 10, 2019
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1560 Broadway, Room 100B, Denver 80202; Dial-in: 720-279-0026, Passcode: 197413
Alternative Payment Models and Primary Care presentation
CIVHC Primary Care Spending Report for DOI 8-27-19
- Aug. 19, 2019
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1560 Broadway, Room 110D, Denver, 80202; Dial-in: 720-279-0026, Passcode: 197413
Rules of Order and Standard Operating Procedures - Primary Care Collaborative
The Importance Of Primary Care—And Of Measuring It - Health Affairs, Aug. 6, 2019
DRAFT - Defining Primary Care - as of 8-12-19
Colorado Assoc. of Health Plans Presentation - Carrier reimbursement practices in primary care
- July 31, 2019
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1560 Broadway, Room 110D, Denver, 80202; Dial In: 720-279-0026, Passcode: 197413
Rhode Island Primary Care Experiment - Health Affairs May 2010
What has been done elsewhere - Primary Care
Definitions of Primary Care 6.1.19
CIVHC Alternative Payment Model and Primary Care Definitions Presentation
- July 8, 2019
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1560 Broadway, Room 110D, Denver, 80202; Dial In: 720-279-0026, Passcode: 197413
Rhode Island Spending Slowed - Health Affairs Feb. 2019
Members
- Collaborative Members
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Jimmy Burds - Employer Representative, Denver Metro area
Laura Coleman - CMS / Consortium for Medicare Health Plans Operatios
Isabel Cruz - Health Care Consumer, Denver Metro area
Amy Dickson - Primary Care Provider, Denver / Mountain Communities
Stephanie Gold - Primary Care Provider, Denver Metro area
Patrick Gordon - Health Insurer Representative, Western Slope
Steve Holloway - Colorado Department of Public Health & Environment
Tracy Johnson - Colorado Department of Health Care Policy & Financing
David Keller - Primary Care Provider , Denver Metro area
Kyra deGruy Kennedy - Health Care Consumer, Denver Metro Area
Greg McCarthy - Health Insurer Representative, Denver Metro area
Gretchen McGinnis - Health Insurer Representative, Denver Metro area
Chris Riley - Health Insurer Representative, Denver Metro area
Miranda Ross - Health Insurer Representative, Denver Metro area
Simon Smith - Primary Care Provider, Northern Front Range
R. Holbrook Stapp - Primary Care Provider, Denver Metro area
Alwin Steinmann - Primary Care Provider, Denver Metro area
Stacy Stein - Health Care Consumer, Western Slope & Mountain Communities
Andrea Stojsavljevic - Health Care Consumer, Denver Metro area
Marsha Thorson - Primary Care Provider, Western Slope & Mountain Communities
Christina Yebuah - Health Care Consumer, Denver Metro area
What does the Collaborative do?
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 is working towards 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.
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.
For more information about the Collaborative, contact Tara Smith, Primary Care and Affordability Director - tara.smith@state.co.us; 720-701-0081.