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Improving Health Care in Colorado – We’re In This Together!

As a primary care provider for the Health First Colorado (Colorado's Medicaid Program) Accountable Care Collaborative (ACC), you are part of a strong health neighborhood of medical and social services providers. In addition, you have the support of CCHA to help serve ACC members in Boulder, Broomfield, Clear Creek, Gilpin and Jefferson counties. We all share accountability and are committed to creating a more integrated, coordinated system of care for this population that offers more value, provides a better experience, and improves overall health.

CCHA is here to help PCPs succeed as a patient-centered medical home for ACC members.

We offer various services, tools and resources to help connect and engage both patients and providers in the health care process.

Care Coordination Support Through Our Unique Health Partners Program

  • Utilize our multidisciplinary team of nurses, social workers and community resource specialists to assist PCPs with care coordination for ACC members – especially those who
    • Call frequently
    • Would benefit from additional disease/medication education
    • Require in-home evaluation
    • Miss appointments or have transportation issues
    • Are diagnosed with complex or chronic disease
    • Frequently visit the hospital or ER
    • Need help connecting with non-medical services
  • Work with providers and patients to develop care plans, support transitions of care, offer community resource guidance, and provide health education

Provider Relations, Network Management & Physician-to-Physician Consultation

  • Connect PCPs to CCHA services and provide assistance with anything related to care for our ACC members
  • Serve as the liaison between providers, the State, and CCHA leadership
  • Educate providers about ACC participation and resources available to support their success
  • Maintain a network of urgent care, dental, and other specialty providers that serve ACC members 
  • Offer direct PCP consultation with our Chief Medical Officer, a family medicine physician, to help navigate the ins and outs of the ACC program

Clinical Quality Improvement & Practice Transformation

  • Help primary care practices adapt to changes and build sustainable processes to deliver comprehensive, patient-centered care through data and continuous quality improvement efforts
  • Support providers and practice staff with CCHA or ACC program key performance measure initiatives

Data & Reporting Support

  • Train on how to access the Statewide Data and Analytics Contractor (SDAC) portal and help understand how to use the data most effectively
  • Deliver reports regarding attributed ACC members including info such as high risk, appointment no shows, and frequent ER utilizers
  • Provide individual practice data showing progress with key performance indicator measures and gaps in care
  • Offer guidance with benchmarking efforts and best practices

Patient Education & Provider Tools

  • Outreach ACC members and provide information about the ACC program and CCHA services
  • Encourage self-management of chronic health conditions and educate about diseases and medications, pregnancy and family planning, community resources for non-medical needs, etc.
  • Provide participating PCPs with tools and materials to help educate patients and succeed with achieving the ACC performance goals

Community Liaison Services

  • Build and maintain relationships with vital organizations in the community and collaborate to ensure members are getting access to needed services
  • Establish efficient processes for bi-directional member referrals and provide updates on current ACC and CCHA initiatives