A year after expanding Medicaid to more low-income Coloradans, state government remains focused on driving value for every dollar spent.
Colorado has been a leader in our efforts to transform the health care system from one that focuses on paying for volume to one that focuses on paying for high-value, low-cost services that improve health.
One example is paying a primary care provider more to keep his office open after hours so that someone could go to his own doctor instead of to a more expensive emergency room to receive non-emergency care. This common-sense approach to incentivizing accessing care in the appropriate setting is better for the client, better for the provider, and better for the taxpayer.
At Colorado Medicaid, we are seeing encouraging results. The total cost of care has begun to level out and there is increased focus on improving the health care outcomes.
We are constantly working to make sure that we’re making strategic investments in our clients’ health that reduce cost but improve outcomes at the same time — and we’ve been successful. Our average cost per client in Medicaid has declined by more than 9 percent since fiscal year 2008-09 and we’re seeing clear signs that health outcomes are improving.
Our primary platform for improving value in Colorado Medicaid is our Accountable Care Collaborative program. This program currently serves 800,000 Coloradans and connects clients to a primary care medical provider. In its first three years, we have seen encouraging results. Last year, for children and adults without a disability, we had double-digit reductions in hospital readmissions and high-cost imaging and reduced emergency room utilization for those who were enrolled in the program for six months or longer.
This program is a nationally recognized model that puts clients and wellness at the center of care and strengthens Colorado’s health care infrastructure, saving taxpayer dollars by avoiding unnecessary services.
We know that the health- care needs of those in the community can look different depending on your location, which is why the Accountable Care Collaborative program is a regional approach that has built upon successful local networks of care and community supports. Providers, counties, community partners, other stakeholders and the General Assembly have been and will continue to be a vital part of transforming our health care system.
We will remain focused on improving value for every health care dollar spent while improving the health outcomes of the more than 1 million Medicaid clients we serve. Beyond coverage, we are promoting prevention and wellness, improving health system integration, and reducing fraud or waste in the system.
Health care coverage is an important first step, continuing to evolve the way we pay for care and engaging clients to take an active role in their care will be our next critical challenges as we work together to make Colorado the healthiest state in the nation.
Susan E. Birch is executive director of the state Department of Health Care Policy and Financing.
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