Rae report pdf

The seven Regional Care Collaborative Organizations RCCOs were responsible for building networks of primary care providers in different geographic regions, coordinating the care of Health First Colorado members and monitoring progress using data. Colorado paid a lump sum to each regional BHO, which arranged for behavioral health care for all Health First Colorado members in its region.

Phase Two of the ACC assumes that by combining the administrative duties of BHOs and RCCOs new efficiencies will be gained, moving the state closer to its vision of integrated physical and behavioral health care. The RAEs cover seven regions. See map at right. There are only five operators because two organizations — Colorado Access and the Colorado Community Health Alliance — were each awarded two regions.

For an expanded version of this report, download the PDF. Colorado Access also served as a BHO. Although BHOs are going away in their current form, many BHOs were partially operated by community mental health centers. Several of these centers also have an ownership stake in the two new RAE organizations. Health care providers have varying degrees of ownership in RAEs. Several are owned by coalitions that include providers.

See graphic at right. The provider-owner arrangement has potential benefits and pitfalls. On the other hand, some perceive a potential conflict of interest when providers partially own an entity responsible for paying their own practices. Sole operators, on the other hand, may have an advantage when it comes to administrative efficiency and coordination, but may be more removed from providers.

RAEs are expected to solicit suggestions from providers and members to inform their strategy and decisions. Each RAE is doing this in different ways. Some have established governance councils made up of health care providers in their network. But the composition of the RAEs raises questions: For example, some RAEs have determined that only providers of a certain size can be members of a governance council, leaving questions of how the RAE will engage with smaller clinics and practices.

RAEs are also establishing advisory councils to inform behavioral health decisions and engage members. Payment is often used as a tool to shift provider behavior and bring about system-wide change. The key takeaway from the graphic that one entity — the RAE — is now responsible for both the PMPM payment or alternate arrangement to primary care providers and payments to behavioral health providers. Some payments have not changed since Phase One. Primary care providers are paid on a fee-for-service basis, and behavioral health services are paid on a capitated rate.

How will changes in attribution affect members and providers? Yet the complicated exercise of linking over a million members to thousands of providers raises many questions, especially because attribution determines the volume of PMPM payments that RAEs receive.

Will HCPF attribute the expected number of members to each provider? How will changes in the way care is paid for in Medicaid impact cost, quality and access to care? There are a few promising areas where this could happen in Phase Two.

First, RAEs can develop innovative arrangements with primary care providers that encourage efficiency and quality. Second, Phase Two continues the emphasis on coordinating care — potentially avoiding duplicative services and ensuring patients get the right care at the right time. Finally, Phase Two places an even greater emphasis than Phase One did on tracking progress through data and measurement, then tying improvement to financial incentives.

How will success be measured? The many elements of the ACC mean that success can be measured in many ways. Cost savings to the state is one; performance on key metrics is another. Phase Two includes the added dimension of public reporting of data. HCPF aims to increase transparency and focus on improving the health of populations by posting a dashboard of metrics. This dashboard includes KPIs and additional clinical and public health measures, such as suicide rates, developmental screening and medication management of asthma.

How will the six behavioral health visits primary care providers can now bill for and other Phase Two changes affect access to behavioral health services? Phase Two includes several ways to improve access to behavioral health services. For example, primary care provider practices or clinics are now allowed to bill for up to six short-term visits to a Medicaid-enrolled, licensed behavioral health clinician in a primary care setting.

Each RAE also has to develop a statewide network of behavioral health providers. Previously, BHOs reviewed behavioral health providers and allowed those it approved to bill for services. The process is called credentialing. Many smaller or independent providers felt shut out of Health First Colorado because they could not get credentialed. Now RAEs are in charge of credentialing in their regions. Some behavioral health providers may have to contract with multiple RAEs in order to serve patients with primary care providers in different regions.

How will RAEs manage the integration of physical and behavioral health? Behavioral health in Health First Colorado is a capitated managed care program. While each RAE either has experience managing behavioral health care or has a managed care organization as a partner, there will still likely be a learning curve for some of them in administering payments, working with providers and providing care coordination services.

You can change your cookie settings at any time. The Commission's report into racial and ethnic disparities in the UK. PDF , ZIP , There have been some amendments to the report since it was published. It balances the needs of individuals, communities and society, maximising opportunities and ensuring fairness for all. The Commission has considered detailed quantitative data and qualitative evidence to understand why disparities exist, what works and what does not.

It has commissioned new research and invited submissions from across the UK. Its work and recommendations will improve the quality of data and evidence about the types of barriers faced by people from different backgrounds.

This will help to inform actions and drive effective and lasting change. This includes the story of slave resistance. One such example is documented in: Buckridge, S.

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