Guest Blogger: Douglas McCarthy
In 2010, the CIVHC-led Data and Transparency Advisory Group set long-term goals for Colorado to move into the top tier of performance among states on key measures of health system performance. Thanks to the collaborative efforts of public and private stakeholders, the state has taken strides to realize these goals. The Blue Ribbon Commission on Health Care Reform forged a consensus on a “Colorado Vision” for change that has enabled the state to build on multiple opportunities made possible by the federal Affordable Care Act (ACA).
The Commonwealth Fund’s Scorecard on State Health System Performance offers Coloradans cause to celebrate these efforts. The state rose from middle of the rankings in 2009 to 8th place in the 2015 rankings, released last December. The greatest gains have come about in access to and quality of care. The state also improved relative to other states on avoiding unnecessary hospital use and is close to realizing the Governor’s commitment to make Colorado the healthiest state in the nation.
To bring these results closer to home, in July the Commonwealth Fund released a companion Scorecard on Local Health System Performance that zooms in on seven “hospital referral regions” anchored in Colorado. 
These regions, defined by the Dartmouth Atlas of Health Care, can be considered local “markets” for health care services. The Local Scorecard assesses 306 such regions across the country on 36 indicators of health care access, quality, efficiency, and health outcomes.
Overall, six of Colorado’s seven regions moved up in the Local Scorecard’s rankings between 
2012 and 2016. The Boulder and Fort Collins regions joined the “honor roll” of the top 30 highest-performing regions in the nation, while the Denver region (which includes parts of neighboring states) moved into the top quintile (fifth) of regions nationwide. The Scorecard recognized Pueblo and Boulder among just 14 regions nationally to substantially improve on a majority of 33 trending indicators.
But the work isn’t done. Inequities in care remain for people of color and those living on lower incomes. Many Scorecard indicators remained essentially unchanged. Benchmarks set by higher performing states and regions offer targets for continued improvement. To help local leaders understand how they can take action, The Commonwealth Fund is conducting case studies of regions such as Pueblo that improved despite socio-economic challenges common to many areas.
Our discussions with state and local leaders point up the value of nurturing cross-sector collaborations such as the Pueblo Triple Aim Corporation, which is fostering a common will for change among health care, public health, social services, and educational stakeholders by setting and measuring progress toward goals. Colorado’s State Innovation Model (SIM) is building on statewide initiatives such as multi-payer support for primary care “medical homes” and regional accountable care in Medicaid.
The Colorado All-Payer Claims Database administered by CIVHC offers an enviable resource for the state to monitor the progress of these and related efforts. We welcome your thoughts on how the state and communities can overcome remaining challenges so that all Coloradans have access to high-quality affordable care and an equal opportunity to live long and healthy lives.
Douglas McCarthy is senior research director for the Commonwealth Fund and serves on the board of CIVHC. He lives in Durango. Email him at dm@cmwf.org. The Commonwealth Fund is a private foundation based in New York City that promotes a high-performing health care system, especially for society’s most vulnerable. The views are the author’s and not necessarily those of the Commonwealth Fund or its directors, officers or staff.