Health Information Exchange Instrumental to Success of State’s First Medicaid ACODate: May 25th, 2011Category: CORHIO e-NewsletterTopics: HIE, Accountable Care
Colorado Springs providers launch pilot Medicaid program to improve patient care
Colorado Springs health care providers are launching the state's first Regional Care Coordination Organization (RCCO) on June 1, which aims to coordinate care across all providers and establish accountability for Medicaid patients' health outcomes while reducing costs. The use of interoperable electronic health records (EHRs) and participation in CORHIO's health information exchange (HIE) will be a vital component of the RCCOs achievement of its functionality and performance.
A RCCO is a regional component of Medicaid's new Accountable Care Collaborative (ACC) program. Medicaid clients in the ACC will receive services using the fee-for-service model, and will also belong to an "accountable care organization" that helps to manage their care. The Colorado Springs region (which includes Park, Teller, El Paso and Elbert counties) is the first of seven to launch in the state of Colorado. [For more information about the ACC program, visit the Medicaid website.]
By collaborating on a regional level, providers will be jointly accountable for the health of their patients, giving them strong incentives to cooperate and control costs and meet specific quality benchmarks.
Collaboration Aims to Improve Patient Outcomes
"The RCCO changes the incentives and health care delivery processes for providers from one that rewards a high volume of services, to one that focuses on the health outcomes of patients," said Carol Bruce-Fritz, executive director of the Community Health Partnership in Colorado Springs, the organization that is leading the RCCO. "The RCCO will help to control costs by avoiding unnecessary tests and procedures and reducing the inappropriate use of health care resources."
In order for the RCCO to operate successfully, it requires a sophisticated technology infrastructure to facilitate its objectives of improving quality and reducing costs. By connecting to CORHIO's HIE network, RCCO providers will have access to patient information, including lab test and pathology results, x-ray, MRI and other imaging reports, and physician transcription reports. Later this year, the network will be upgraded to include patient medication lists, allergies and immunizations as well as lab and imaging orders.
HIE Enables RCCO's Patient-Centered Care Coordination
Colorado Springs Health Partners (CSHP), a multi-specialty group practice, is one of several health care organizations to participate in the pilot Medicaid program.
"Currently, the providers in our area function as isolated entities and there is no way to electronically communicate," said Debbie Chandler, CEO of CSHP. "The HIE is necessary to the RCCO's goal of patient-centered care coordination. Our providers will rely on the HIE to enable communications with other RRCO participants, manage patient identities, provide record locating services, establish registries and be a gateway to external networks."
Dr. Judy Zerzan, chief medical officer of the state Department of Health Care Policy and Financing (HCPF), which has been integral to the formation of RCCOs adds, "Technology is a key tool in the success of the Medicaid RCCO pilot. Through EHRs and the health information exchange, we will have the ability to track what's going on with our patients, enabling us to coordinate care more closely and carefully manage our patients. Eventually, our goal is to provide more data in terms of claims and utilization, which will help both individual providers and the RCCO to identify places for practice improvement."