Colorado Multi-Payer Collaborative: Lessons Learned for Primary Care Improvement

Executive Summary

The Colorado Multi-Payer Collaborative (MPC) was a voluntary association of health care payers that convened from 2012 through 2021 to coordinate efforts to improve primary care and reform health care payment in the state. As part of the MPC, members participated in federal primary care transformation initiatives such as Comprehensive Primary Care (CPC), Comprehensive Primary Care Plus (CPC+), and the Colorado version of the State Innovation Model (SIM).

Over the course of the 10-year collaboration, the MPC developed a collegial culture for the exchange of ideas, information, and perspectives on the challenges of primary care reform, along with a pragmatic, outcomes-oriented focus on health care transformation in Colorado. At the height of the MPC’s activities (2018 to 2019), it supported more than 250 practices and nearly 2,100 individual providers across Colorado.

During their work together, MPC members initiated and participated in significant efforts to transform primary care in Colorado and lay the foundation for the transition from fee-for-service to pay-for-value care. Among other activities, the collaborative built and maintained trusted and productive relationships among public and private health care plans in Colorado; conducted two to four symposia per year where stakeholders shared innovations and lessons learned; aligned quality measures for pediatric and adult primary care; and facilitated the development of a tool (Stratus) that aggregated multi-payer claims data from health plans. A simple comparison of active and inactive Stratus users revealed that active users had 46% fewer emergency department admissions per 1,000 patients and 92% fewer 30-day readmissions.

This report summarizes observations from interviews with members of the MPC, state and federal collaborators, and health care practitioners who participated in primary care transformation initiatives undertaken by the MPC. Some of the observations and lessons learned were gleaned from a survey of providers that the MPC conducted in the spring of 2022. Among other factors, the MPC’s successes can be attributed to:

• the shared vision and values of its members;
• the use of a neutral convener and facilitator; an emphasis on communication between all levels; standardized quality data and procedures;
• the framework for whole-centered care; and
• simplified data collection.

MPC members navigated a number of significant challenges along the way, responding to evolving federal health care reform initiatives, fundamental changes in the health care market in Colorado, changes in state health care regulation and administration, and the unprecedented challenges of a global public health emergency. Although the program has ended, many Colorado practices are continuing the innovations it brought about.

Read the report