Alternative Payment Models

Alternative Payment Models in Colorado

As health care costs continue to rise across the country and in Colorado, many in the industry are working to find solutions to curb rising costs while improving quality of care and the health of Coloradans. Alternative Payment Models (APMs) are seen as a way to help providers and systems achieve lower cost, higher quality care. This report shows which APM models are being used by payers across the state and what percent of total payments made to providers are paid for through an APM. Trend information is also available to track progress towards these new payment models in Colorado.

Use Cases

Policymakers
  • Use this information to track progress on legislation and other initiatives aimed at increasing the adoption rates of APMs in Colorado.
  • CIVHC provides an annual report of primary care and alternative payment models (APM) spending to the Colorado Insurance Commissioner for use by the Primary Care Payment Reform Collaborative which aims to reduce health care costs by increasing utilization of primary care.

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Payers
  • Use the statewide APM data to benchmark how your APM percentages compare to the rest of the state by payer and by type of APM.
Providers
  • Understand the types of APM innovations underway, evaluate your current position, and implement practice or system-level changes that may support success under new models.
Researchers
  • Evaluate how APMs in Colorado have changed over time and use this information paired with other data to research the cost and quality impact of these programs.
Employers
  • Engage with your third-party administrators (TPA) and administrative service organizations (ASO) to understand how they can utilize APMs to drive down costs and improve care for your employees.