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Colorado Facilities Selected for Medicare Innovations Programs

In January, the Center for Medicare & Medicaid Innovation (CMMI) announced that several Colorado hospitals and facilities would be participating in programs to reduce health care spending and improve care for Medicare beneficiaries. The programs, Medicare Shared Savings Accountable Care Organizations, Bundled Payments for Care Improvement (BCPI), and the Community-based Care Transitions Program (CCTP) use innovative patient-centered approaches and financial incentives to coordinate care and improve costs.

The Denver Regional Council of Governments (DRCOG), the designated Area Agency on Aging in the metro Denver area, is the coordinating entity participating in the Community-based Care Transitions Program. Under the CCTP program the expansive community partnership of hospitals, skilled nursing facilities, home health agencies, and various non-profit entities will work together to coordinate patient care across the continuum. The multi-system hospitals include Exempla Saint Joseph Hospital, Medical Center of Aurora, Sky Ridge Medical Center, Swedish Medical Center, Presbyterian/St Luke's Medical Center, North Suburban Medical Center and Rose Medical Center, an excellent demonstration of the collaborative nature of Colorado's health care system.

Five Colorado hospitals were selected to participate in the Bundled Payment for Care Improvement program including three Exempla hospitals, University Hospital, and Penrose-St. Francis in Colorado Springs. Exempla's St. Joseph, Good Samaritan and Lutheran hospitals will be working to reduce costs under a bundled payment arrangement for episodes of care related to major joint replacement for lower extremities. Both University and Penrose-St. Francis are focusing on bundled payments for Medicare patients with Congestive Heart Failure with Penrose-St. Francis also looking at episodes related Coronary Artery Bypass Surgery.

Centura Health system was announced as the first Colorado entity to participate in the Medicare Shared Savings Accountable Care Organization. Centura joins Colorado's Physician Health Partners as the second Medicare ACO in the state. PHP began work as a Medicare Pioneer ACO in 2012. Under the shared savings ACO model, Centura will be coordinating care for approximately 8,000 Medicare beneficiaries and will focus on using a medical home "neighborhood" to keep patients healthy and avoid unnecessary visits to the hospital and Emergency Room.

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