In 2017, CIVHC was selected as the state sponsor by  Catalyst for Payment Reform (CPR) to help develop Colorado Payment Reform Scorecards to determine what percentage of payments across the state are paid for using alternative payment models, and the impact those payments have on quality and outcomes. Funded through joint grants from the Robert Wood Johnson Foundation and the Laura and John Arnold Foundation, The Colorado Scorecards on Payment Reform were based on data submitted by commercial insurance plans and Colorado’s Medicaid department regarding their alternative payment models, which together insure approximately 3.5 million Coloradans. The information was then coupled with quality data collected from various local and national sources including claims in the Colorado All Payer Claims Database.

Findings

  • Over half of the health care payments (57%) paid to doctors and hospitals in Colorado by the commercial sector in 2016 contain incentives to improve quality of care patients receive.
  • 54% percent of payments in Colorado’s Medicaid market were tied to value in 2016.
  • In the commercial market, payments tied to value were equally prevalent in primary care and specialists (68%), with hospital payments tied to value trailing slightly at 64% of total dollars.
  • In the Medicaid market, 100% of payments to hospitals were tied to value, with quality performance incentive payments making up 7% of total dollars paid to hospitals in 2016.