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Colorado presents its primary‑care investment target: APCD shows ~15.7% primary‑care spending
Summary
Colorado officials told the Washington board that a 2019 legislative framework and regulations led to an incremental primary‑care investment target; APCD data indicate Colorado’s primary‑care spending was about 15.7% of total medical expenditures in the most recent report and roughly 60% of that spending was reported flowing through alternative payment models (APMs).
Colorado officials described a multi‑pronged, legislature‑backed approach to primary‑care investment: a state‑level Primary Care Payment Reform Collaborative (PCPRC) to define primary care and set investment targets, use of the APCD to measure spending, and regulatory authority for the commissioner to include affordability standards in rate review.
Tara Smith, who leads Colorado’s Primary Care Payment Reform Collaborative, said Colorado promulgated an initial regulation effective Jan. 1, 2021 that set an incremental investment target and encouraged payers to increase primary‑care spending by one percentage point in early years. "As a state, we're sitting about 15.7% based on APC data of total medical expenditures that are flowing through primary care spending," Smith said, referencing Colorado’s most recent APCD results.
Smith also reported Colorado’s reporting framework captures claims and non‑claims spending and that roughly 60% of reported primary‑care spending is flowing through APMs, though she told the board providers sometimes question whether contract language reflects their lived experience. Matt Sundin described Colorado’s Medicaid Accountable Care Collaborative (ACC), noting roughly 1.2–1.3 million members are enrolled and describing RAE payments to support primary care. Sundin said per‑member per‑month payments to RAEs typically range from about $12 to $19 and that RAEs are required to pass at least 33% of those funds on to primary‑care networks.
Board members asked about whether the state had seen measurable cost or outcome improvements tied to the investment target; Colorado staff said improved reporting exists but the effects on outcomes and commercial spending are mixed and methodological changes complicate year‑to‑year comparisons.
