The Ways of the RAES: Regional Accountable Entities and Their Role in Colorado Medicaid’s Newest Chapter

Abstract

This report explains the major changes to the organizational structure of the state’s Medicaid program that are part of Phase Two of the ACC. It also poses questions to consider as these developments in Health First Colorado take hold. Phase Two involves a number of changes aimed at coordinating care and reducing costs. The biggest development was the launch of seven new organizations- Regional Accountable Entities- RAEs — on July 1, 2018. The RAEs’ responsibilities include ensuring Health First Colorado members have access to primary care and behavioral health services, coordinating members’ care and monitoring data to ensure members are receiving quality care. They also have a role in paying providers, including managing payments for behavioral health services and using bonus payments to encourage primary care providers to improve care — responsibilities largely carried out by other entities in Phase One