Colorado health plans collaborate to create data-sharing solution for care providers

Comprehensive Primary Care (CPC) initiative-driven effort brings aggregated actionable data to clinicians' fingertips

Dec 03, 2014, 12:00 ET from Western Colorado Leadership Group

DENVER, Dec. 3, 2014 /PRNewswire/ -- Seven health plans in Colorado are collaborating on a multi-payer data-sharing online tool that aims to enhance and improve the delivery of care for Colorado residents.

The idea emerged from the Comprehensive Primary Care (CPC) initiative, a national collaboration among public and private health plans to strengthen primary care. Health plans participating in the Colorado CPC (CO CPC) are working together to make it easier for primary care practices to transition to a more integrated, family care centered approach to serving patients.

Care providers currently receive multiple reports from each health plan and have to log on to several different websites to access patient data, making it cumbersome and inefficient for care providers to coordinate a patient's care.

However, CO CPC members are now developing a single source for patient-level information that will help care providers save time and resources, enabling them to spend more time with patients.

A majority of the payers participating in CO CPC agreed to finance an innovative tool that allows care providers to access their patients' claims data from one website. Rise Health will partner with Colorado's Center for Improving Value in Health Care and other state and local entities to build the tool and help ensure a comprehensive approach to data aggregation.

"This initiative represents a major step forward for both providers and payers in Colorado. For the first time, physicians will be able to access actionable, patient-specific data across multiple insurers and self-funding employers in a single analytic tool," said Patrick Gordon, associate vice president at Rocky Mountain Health Plans.

A single reporting solution will provide more accurate patient-level reporting and information. For the first time, health care practices will be able to look at patient care across the entire spectrum of services. Ultimately, it will enable physicians and health plans to benchmark their practices in a more efficient manner. "We are moving into a new era of health care and it is exciting to be a part of providing this level of data to the providers of care, especially in rural areas," said Cindy Palmer, CEO of Colorado Choice Health Plans.

"This represents an innovative solution to a longstanding problem. Too often, it's either feast or famine; providers either lack sufficient information or they are bombarded with too much. Now, we can provide them the right amount of information at the right time," said Kelly Henry, network director, payment innovation programs at Anthem Blue Cross Blue Shield.

"Colorado continues to play a leading role in developing innovative solutions that build deeper relationships with care providers and help increase quality of care and reduce costs for patients," said Beth Soberg, president and CEO of UnitedHealthcare of Colorado. "This new initiative will simplify care providers' ability to access important patient information to help better manage population health."

Over the past two years, the payers looked at the evidence, listened to physician leaders, agreed on common measures of success, and collaborated on a rigorous, competitive process that resulted in an aggregated-data solution that is both practice-focused and patient-centered, while meeting the unique needs of the Colorado market.

Colorado Medicaid is hopeful that the multi-payer agreement, and the selection of Rise Health as the vendor, marks the beginning of another, much longer, process. The payers are committed to sustainable practice transformation in Colorado, and data aggregation may be one piece of a longer-term strategy.

"We're building on the CO CPC opportunity, but it's just a launching pad. We believe we've created a program that is the beginning of a long collaboration to help improve Colorado's health care system," said Dr. Judy Zerzan, chief medical officer and deputy director, Colorado Department of Health Care Policy and Financing (Colorado Medicaid).

The following payers are participating in the data aggregation solution:

  • Anthem Blue Cross and Blue Shield
  • Cigna
  • Colorado Access
  • Colorado Choice Health Plans
  • Colorado Medicaid/Colorado Department of Health Care Policy and Financing
  • Rocky Mountain Health Plans
  • UnitedHealthcare

Practices can expect access to the data aggregation tool in the first quarter of 2015; details about implementation will be available soon.

About the CPC initiative
The Comprehensive Primary Care initiative is a national pilot to foster collaboration among public and private health plans to strengthen primary care. The Centers for Medicare & Medicaid Services Innovation Center launched the CPC initiative in 2012. The ultimate goal: Establish a new national model for the purchase and delivery of comprehensive primary care that will enhance care management, improve health and reduce costs throughout the country. Colorado was one of only seven markets selected to participate in the pilot. Practices receive support from all participating payers to better coordinate primary care for their patients.

About Anthem Blue Cross and Blue Shield in Colorado
Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc., an independent licensee of the Blue Cross Blue Shield Association. ANTHEM® is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Colorado is available at www.anthem.com. Also, follow us on Twitter at www.twitter.com/healthjoinin, on Facebook at www.facebook.com/HealthJoinIn, or visit our YouTube channel at www.youtube.com/healthjoinin. Media inquiries should be directed to Joyzelle Davis at joyzelle.davis@anthem.com, or (303) 831-2005.

About Cigna
Cigna Corporation (NYSE: CI) is a global health service company dedicated to helping people improve their health, well-being and sense of security. All products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, Life Insurance Company of North America and Cigna Life Insurance Company of New York. Such products and services include an integrated suite of health services, such as medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products including group life, accident and disability insurance. Cigna maintains sales capability in 30 countries and jurisdictions, and has approximately 85 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com. Media inquiries should be directed to Michelle Vroom at michelle.vroom@cigna.com, or (267) 606-5822.          

About Colorado Access Founded in 1994, Colorado Access is a local, nonprofit health plan serving more than 950,000 Coloradans. The company's members receive healthcare under Child Health Plan Plus (CHP+), Medicaid behavioral and physical health programs, long-term support, and/or Medicare Advantage. Colorado Access provides care coordination and management for three (3) of the seven (7) Regional Care Collaborative Organizations under Colorado's Accountable Care Collaborative Medicaid program. To learn more about Colorado Access, visit coaccess.com. Media inquiries should be directed to Palwasha (Sasha) Khan at Palwasha.Khan@coaccess.com, or (720) 744-5436.

About Colorado Choice Health Plans Colorado Choice Health Plans in a not-for-profit organization that has served rural communities in Colorado for over 42 years. Over the past few years the Company has moved into several urban/suburban communities as well. Colorado Choice provides products and services for small and large employer groups, individuals, Medicare beneficiaries, and the Child Health Plan Plus (CHP+) as well as participating with Connect for Health Colorado (the Colorado Healthcare Exchange). Colorado Choice Health Plans offers personal service and is committed to the members and communities served. We are dedicated to improving member's quality of life through the delivery of health care coverage and health and wellness programs for our members and our communities. To learn more, visit www.chochoice.com. Media inquiries should be directed to Cindy Palmer at cpalmer@cochoice.com, or (719) 589-3696.

About the Colorado Department of Healthcare Policy and Financing The Department administers the Medicaid and Child Health Plan Plus programs as well as a variety of other programs for low-income Coloradans who qualify. For more information about the department, please visit Colorado.gov/hcpf. Media inquiries should be directed to Marc Williams at marc.williams@state.co.us, or (303) 866-3144.

About Rocky Mountain Health Plans Founded in 1974 in Grand Junction, Colorado, as an independent, not-for-profit health insurance provider, Rocky Mountain Health Plans uniquely understands the needs of Coloradans. We provide access to affordable, high quality health care enabling our almost 300,000 Members to live longer, healthier lives, while maintaining our mission to put people before profits. Rocky Mountain Health Plans is the only health plan in Colorado to serve every market segment, including individuals, families, employers, Medicare, Medicaid, and Child Health Plan Plus beneficiaries. The National Committee for Quality Assurance (NCQA) recently awarded Rocky Mountain Health Plans a commendable status for continuously improving the quality of care and services provided to Members. For more information, visit rmhp.org or connect with RMHP on social media @RMHPColorado on Facebook, @RMHP on Twitter, @rmhpColorado on Pinterest, and @rmhpcolorado on Instagram. Media inquiries should be directed to Leanne Hart at Leanne.hart@rmhp.org, or (970) 263-5511.

About UnitedHealthcare UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers.The company offers the full spectrum of health benefit programs for individuals, employers, military service members, retirees and their families, and Medicare and Medicaid beneficiaries, and contracts directly with more than 800,000 physicians and care professionals, and 6,000 hospitals and other care facilities nationwide. Globally, UnitedHealthcare serves 45 million people in health benefits and is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company. For more information, visit UnitedHealthcare at www.uhc.com or follow @myUHC on Twitter. Media inquiries should be directed to Kristen Hellmer at Kristen_hellmer@uhc.com, or (602) 255-8466.

About Rise Health Acquired by Best Doctors, Inc. in 2014, Rise Health creates personalized care experiences by combining actionable data insights and medical excellence. The company provides payers, provider organizations and employers the tools and services necessary to improve the quality of care, lower costs and enhance care interactions. The Rise Solution Suite includes the Ascend Enterprise Data Aggregation Platform, Stratus Predictive Healthcare Analytics Application, the Cirrus Patient Relationship Manager, as well as local access to the best minds in the global medical community. To learn more, visit www.risehealth.com. Media inquiries should be directed to Amanda Cecconi at Amanda@punchingnungroup.com, or (615) 473-7536.

The entities above are all a part of the Western Colorado Leadership Group.

SOURCE Western Colorado Leadership Group