A statewide effort to help Medicaid patients better manage their health care saved $31 million in taxpayer dollars, according to recently released state data.
The state agency that manages Medicaid launched the Accountable Care Collaborative to help Medicaid patients understand their benefits.
Over the last two years, the state saved $9 million through the program. Officials saw an increase in savings in the last fiscal year as participation increased.
“We are very pleased with this year’s savings but even more excited to see that the program still continues to save money and improve care as it grows,” said Laurel Karabatsos, the Colorado deputy Medicaid director.
The program, which started in 2011, has increased enrollment in the collaborative from 132,000 Medicaid patients to 609,000, or about 60 percent of all Medicaid patients in Colorado. Regional data was not immediately available.
Medicaid is a government-funded form of health insurance. In Colorado, it was expanded in January, making residents earning up to 133 percent of the federal poverty level eligible.
In La Plata County, Medicaid patients receive help managing their benefits through the Nurse Navigator program at the San Juan Basin Health Department.
The Nurse Navigator service was in place before the state introduced its program. So, the state partnered with the health department to bolster the existing program.
The agencies helping patients use their Medicaid benefits are different all across the state. But they all focus on reducing unnecessary readmissions to the hospital, visits to the emergency room, the use of high-cost imaging (like CT scans) and redundant procedures.
Rocky Mountain Health Plans manages the state’s program on the Western Slope, an area that includes 100,000 Medicaid enrollees. It directly helps local doctors by providing information about patients to their primary-care doctors, said Dr. Cecile Fraley, the physician administrator for Pediatric Partners of the Southwest.
This allows clinics to directly follow up with patients after emergency-room visits, she said.
Through the program, the Colorado Department of Health Care Policy and Financing has found the longer patients on Medicaid receive care coordination, the lower their rate of readmission to the hospital.
Adults receiving help managing their health care for more than six months had 33 percent fewer hospital readmissions, according to the data.
“When people first get benefits, they need some education,” said Marc Williams, a representative of the department.
This trend may also be driven by a pent up need for medical attention that Medicaid patients may have when they first enroll in Medicaid, Karabatsos said.
The program has similarities to the managed-care model that ended in the early 2000s. In that model, the cost of treatment was monitored by a company. However, Colorado Medicaid patients can still choose their doctor and decline to receive help coordinating care. Only 3 percent of the patients invited to join the program have opted out, state officials said.