Experts in Value-Based Care
CHPA involves key clinical staff from our member organizations to monitor quality outcomes, adhere to evidence-based guidelines, and ensure ongoing evaluation of our members. Ongoing feedback is provided to CHPA members to show how their performance matches up to the guidelines as well as to their community partners and peers.
Mission: To improve the quality and cost of care for the people our members serve.
Vision: To be an admired nonprofit leader in value-based care focused on individuals and communities.
• Accountability – we rely on one another to deliver excellence and are mindful of our impact on patient care
• Adaptability – we innovate, informed by data and network needs
• Community – we build a diverse environment that is equitable and inclusive
• Compassion – we act with empathy, kindness, and understanding
CHPA strives to achieve the Quadruple Aim. This is accomplished through various initiatives to improve care transitions and best practices, by developing alternative payment methodologies, and advocating for payment reform. With partners like the Colorado Community Health Network (CCHN) and the Colorado Community Managed Care Network (CCMCN), these joint efforts lead to improved population health, reduced cost of care, enhanced patient experience, and improved care team satisfaction.
CHPA leverages the strength of our member CHCs integrated primary care model. This model centers the care around the patient by offering high quality physical, behavioral, and dental services. These clinical services are combined with various other programs like payer enrollment, care management, patient education, and patient navigation to also address the Social Determinants of Health (SDoH) such as food, housing, transportation, and more. Patients benefit by having affordable high-quality comprehensive care provided in their communities, in one location, centered and coordinated around the patient’s full spectrum of health and social needs.
To increase long-term sustainability CHPA has partnered with various payers across the state and nation, entering into various value-based contracts to set quality goals. By empowering member CHCs with enhanced resources they can more effectively care for their patients and reach their goals. With proven success in achieving contract goals, the CHPA network maximizes its performance while reinvesting additional revenue in their systems. Through these endeavors, the patients have access to a high-quality integrated primary care delivery system.
CHPA has several ongoing programs in the areas of the patient-centered medical home, clinically integrating EHR data, and improving health outcomes, with demonstrable results. CHPA involves key clinical staff from our member organizations to monitor quality outcomes, adhere to evidence-based guidelines, and ensure ongoing evaluation of our members. Ongoing feedback is provided to CHPA members to show how their performance matches up to the guidelines as well as to their community partners and peers.
CHPA is a Colorado non-profit 501(c)(3) tax-exempt organization. Membership in CHPA is open to Colorado tax-exempt organizations that are officially designated as Federally-Qualified Health Centers (FQHCs) or FQHC ‘look-alikes’ as defined by Section 1905 of the Social Security Act. Also commonly referred to as Community Health Centers (CHCs).
Initiatives for Success
CHPA members agree to work as an accountable care organization focused on adopting and implementing best practices to improve the health and well-being of our patients. They agree to adopt and adhere to evidence-based clinical guidelines. CHC clinics and providers are required to actively participate in CHPA activities and initiatives to improve the quality, efficiency, and coordination of patient care, including:
- Participation in clinical education, care coordination activities, and regular clinical and quality improvement meetings,
- Critical review of performance data and testing and demonstrating improvements and progress toward our common goals,
- Implementation of population health management strategies, including technology, to improve systems, care coordination, and population management, and
- Adherence to clinical guidelines, as demonstrated by performance on nationally endorsed measures and defined performance targets.
High-Performing Primary Care
CHPA works with CHCs on improving and implementing best practices as described in the 10 Building Blocks of High-Performing Primary Care. Working in conjunction with CHCs and payers, CHPA acts to develop alternative payment methodologies and payment reform, decreasing overall healthcare costs, and increasing patient satisfaction, all of which give our patients access to a high-quality integrated primary care delivery system. CHPA does not own or manage health centers but rather was formed to work for those members and provide vital support to help deliver the best possible care for patients. Our CHCs value high-quality healthcare and we help them deliver it.
Value-Based Care Contracts
By participating in CHPA, members have access to various payer contracts and payment models which provide incentives through value-based contracts to ensure long-term stability. We work with all types of payers, including Centers for Medicare & Medicaid Services (CMS), the State’s Medicaid office, Medicare Advantage plans, Managed Care Organizations, foundations and private entities, and commercial insurance payers. CHPA has extensive contract negotiation and contract management expertise in-house. We negotiate primary care capitation, professional capitation, pay for performance and ACO incentive programs, per member per month (PMPM) performance-based incentives, and shared savings contracts.
Through shared data and analytics, our ACO uses national standards and comparative peer results to identify improvement opportunities and lessons learned. Our aim is to give our members meaningful and timely reporting to achieve the best possible results and improve the lives of our patients. We perform highly specialized analytics to identify best practices, improve outcomes and performance, and establish partnerships with cost-effective, high-quality mission-aligned specialists, hospital and ancillary providers.
Pillars of Support
Here at CHPA, we are having regular conversations with new and existing payers to move forward in the continuum from fee for service, to pay for performance, and VBC contracts. We are also seeing connections between the work we do and how that parallels with the goals of the Colorado Department of Healthcare Policy and Financing (HCPF) and their Accountable Care Collaborative as that program moves into the third phase.
- Contract management and advisement: assistance with understanding contracts, terminology, and other nuances specific to payer arrangements.
- Value-based contract modeling: designing effective alternative payment models, capitation, and value-based contracts (PMPMs, ACO/QI incentive programs, shared savings and risk-based models).
- Regular distribution of funds achieved through value-based contracts back to members to support ongoing performance improvement.
- Educational webinars and training for providers, nurses, operations staff, care management, coders, etc. to accurately capture the complexity of our population.
- In-house AAPC coding courses to support coders becoming Certified Professional Coders (CPC) and Certified Risk Adjustment Coders (CRCs).
- Coding peer group coordination for education and best practice sharing.
- Pre-visit planning for Annual Wellness Visits (AWVs) and other Medicare visits.
- Monthly educational webinars.
- Opportunities for sharing innovations and best practices being piloted across membership.
- Quarterly performance reviews to collaborate and make changes for improvement.
- Clinic-specific improvement activities to assess, evaluate and re-tool current workflows/processes.
- Annual Wellness Visit (AVW) training, resources, and support to appropriately document and bill for AWVs.
- Workgroups covering various departments including patient engagement, pharmacy, emergency department utilization, and care management.
- Guides and tools released quarterly to assist with advancing patient centered medical home and team-based care strategies.
- Monthly and quarterly report data to help reduce health disparities and prioritize patient care.
- Increased understanding of patients’ activity outside the clinic through utilization management, including emergency room visits and hospitalizations.
- Population health strategies including alignment with quality metrics across payers.