Department of Health Care Policy & Financing (HCPF), which administers the Medicaid and SCHIP programs is working with the Department of Public Health and Environment to implement 2007 legislation that requires the HCPF to maximize the number of children served by Medicaid or SCHIP who have a medical home. The Governor has a stated goal that "270,000 Medicaid and CHP+ children will have a medical home by 2010 with increased reimbursement to providers who meet medical home standards." Colorado is building on a pilot program to improve delivery of EPSDT services. Colorado is considering a variety of strategies for achieving its goals including enhanced reimbursement and the redesign of the EPSDT administrative case management program so that "medical home navigators" are situated throughout the state offering client education and supporting provider practices. Efforts are ongoing statewide to build infrastructure to support the increased use of health information technology (HIT) to improve the quality of health outcomes for all state residents.
The Colorado Clinical Guidelines Collaborative has convened a formal multi-payer pilot to implement medical homes for adults with chronic conditions in the Denver area. The 2-year pilot is due to be implemented in 2009. Ten to 15 practices are being selected through an application process. In order to apply practices must (1) be Family or Internal Medicine practices (2) be located on the Front Range (Ft. Collins to Colorado Springs), and (3) have >50% combined payer mix from the participating plans. Practices will sign an MOU and be required to achieve NCQA-PPC Level 1 status by April 2009. They will receive technical assistance and support, and be reimbursed under the PCPCC recommended three-tier model (fee-for-service, care management fee and pay for performance) Colorado Medicaid is participating in this effort.
