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In This Issue

Debt, Data and Deciders

What's All This About Risk Adjustment and Burden of Illness?

"Doc Fix" and the Potential to Improve Readmissions

Spotlight on Innovation: Western Colorado Pilots New Medicaid Payment Models

CIVHC In the News

APCD Spot Analysis - Utilization of PT/OT, Acupuncture, Chiropractic and Massage in the Commercial Insurance Market

Annual CO APCD Report to the Governor and General Assembly Released

New Report to Accelerate Successful Payment Delivery and Reform

Recent News

'Unfettered nursing' required for Coloradans desperate for care

Aguilar to introduce bill to reverse high health costs

Can anyone stop the power of Premera?

Behind the cover story: Katie Kerwin McCrimmon on sky-high health costs in parts of Colorado (Video)

The Doctor's Team Will See You Now

Medicaid: Innovation and the Future of Healthcare

How to Bring the Price of Health Care Into the Open

Doctor shortages profound for Plains, Medicaid patients

Debt, Data and Deciders

By Dr. Jay Want, CIVHC Chief Medical Officer

Originally featured in the Colorado Medical Society's February 2014 edition of Colorado Medicine as part I in a series on "Turning healthcare into a functional market system."

The landscape in American health care is changing, and it's affecting us here in Colorado.

At CIVHC we talk about three major trends in American health care: debt, data and deciders. These tsunamis of change are affecting every aspect of American life, not just health care. Let's look at each of them.

What's All This About Risk Adjustment and Burden of Illness?

By Jonathan Mathieu, CIVHC Director of Data and Research

First installment in a series dedicated to helping Coloradans better understand health care claims data on www.cohealthdata.org!

If you've spent time looking at health care cost, utilization and quality data (and who hasn't!), you have no doubt come across the terms risk adjustment and burden of illness. Unless you are a down in the weeds health policy data wonk (that term is used here in the most affectionate way!), you may be utterly baffled as to what all of this means.

"Doc Fix" and the Potential to Improve Readmissions

By Kristin Paulson, CIVHC Senior Manager of Policy and Initiatives

Originally featured in the Healthy Transitions Colorado March newsletter.

There has been a lot of buzz lately about the "doc fix" or the proposed repeal of the Medicare Sustainable Growth Rate formula (SGR). The SGR was put into law in 1997 as part of an attempt to regulate Medicare spending and essentially linked physician Medicare reimbursement to an economic target.

Spotlight on Innovation: Western Colorado Pilots New Medicaid Payment Models

By Stephanie Spriggs, CIVHC Program Assistant

Health care is traditionally a fee-for-service system and Colorado Medicaid program is no exception. However, on the Western Slope of Colorado, Medicaid, Rocky Mountain Health Plans (RMHP) and several partnering provider and community organizations are testing new payment methodologies that could drastically change the way care is paid for and delivered.

CIVHC In the News

Long-distance Medicine Draws Patients

Denver Business Journal Story by Ed Sealover

A small but growing number of major U.S. employers are signing deals to send workers who need non-emergency surgery to faraway hospitals.

Colorado's Elusive Goal: A Complete, Useful Health Care Price List

NPR and Kaiser Health News Story by Eric Whitney

Colorado is one of eleven states that are starting to make a lot of health care prices public. It's taken years.

APCD Spot Analysis - Utilization of PT/OT, Acupuncture, Chiropractic and Massage in the Commercial Insurance Market

Click to enlarge

Analysis of commercial health insurance claims in Colorado's All Payer Claims Database (APCD) shows that utilization of physical therapy/ occupational therapy, acupuncture and massage therapy services declined from 2009-10 and remained relatively steady from 2010 to 2012. Utilization of chiropractic services has fluctuated a bit more but has also been relatively steady, although it is showing a more marked upturn than the other services analyzed.

Annual CO APCD Report to the Governor and General Assembly Released

As administrator of the Colorado All Payer Claims Database, CIVHC is required to submit an annual report to the Colorado Governor and General assembly. This year's report highlights significant achievements made over the course of 2013 and upcoming 2014/2015 milestones including:

Achievements: Enhanced reporting capabilities available and an increase in the use of data available publicly on cohealthdata.org, addition of new payer types, and national recognition for "Innovation in Data Dissemination" by the National Association for Health Data Organization.
Future milestones: Addition of Medicare data and consumer-focused public data comparing pricing and quality of health care services by named facility in Colorado.

Download the Report

Making the Business Case for Payment and Delivery Reform

The Network for Regional Healthcare Improvement (NRHI), a leader in transforming U.S. health care, released a new report, funded by the Robert Wood Johnson Foundation (RWJF), titled Making the Business Case for Payment and Delivery Reform. This report describes a ten-step process for developing a business case to support successful reforms in both health care payment and delivery systems.

NRHI Report Full Text

Stay on Top of Important Reform Updates!

Looking for more ways to keep apprised of Colorado and national health care reform activities focused on the Triple Aim? Click on one of the links below to follow or like CIVHC today!

The Center for Improving Value in Health Care is a non-profit, collaborative organization supporting the Triple Aim for health care in Colorado: better health, better care, and lower costs. We would like to thank The Colorado Trust, the Colorado Health Foundation, Rose Community Foundation and Caring for Colorado for providing funding to support our organization and focus areas.