In 2009, national experts pointed to pockets of excellence across Colorado with innovative efforts to hold down health care costs while producing better outcomes. Still, as Atul Gawande, MD, notes, transforming large, decentralized and inefficient industries takes time. And clearly much work remains to be done as Colorado performs less well than most states on quality (34th), access (40th) and equity (41st) indicators.

New models and methods that strive to provide incentives, improve affordability and increase the quality of care are being tested across the state. These efforts range from medical home pilot projects, to accountable care organizations, to private-sector experiments with payment reform and more. While many of these efforts focus on a single service or are specific to a limited set of providers, payers or communities, it is likely that the most promising of these innovations will receive a boost from federal health care reform.

Among these efforts to improve the health care system, Trust support includes:

• The Center for Improving Value in Health Care (CIVHC). Situated within the Colorado Department of Health Care Policy and Financing, CIVHC is working to identify and implement strategies that contain health care costs and ensure that safe, quality health care services are available to all Coloradans. This public-private coalition of health care providers, payers, state agencies, businesses, consumers and policymakers has set out to improve the quality and timeliness of patient care and overall population health, bend the cost curve and make health costs and quality data more transparent.
• In its second year, the Colorado Patient-centered Medical Home Pilot is being explored as a means to improve health care delivery by aligning high quality, coordinated care with financial incentives. Both public and private insurers are participating in this innovative pilot project. Managed by Health TeamWorks (formerly the Colorado Clinical Guidelines Collaborative), this effort is underway in 17 family medicine and internal medicine practices along the Front Range.
• In providing support services to private pediatric and family medical practices, the Colorado Children's Healthcare Access Program (CCHAP) is helping physicians to increase their ability to care for more children enrolled in Medicaid and CHP+. Early results show the percentage of pediatricians and family doctors along the Front Range, who are able to care for publicly insured children, has increased over the past three years from 20% to 90%. As well, emergency room visits of publicly insured children in this region have been cut in half. Looking forward, CCHAP is expanding their efforts to develop a similar model for prenatal care.

LOOKING AHEAD, The Colorado Trust is supporting strategies to:

• Coordinate health care services, reduce costs and improve health outcomes
• Improve quality and safety of care
• Support innovative programs that advance efficiencies and reduce costs of care.

See a list of all grantees receiving support from The Colorado Trust to Improve Health Systems.