The SDAC takes Medicaid eligibility and claims data, consolidates it in a repository on a monthly basis and gives primary care providers, regional collaborative organizations and Medicaid officials analysis on utilization, spending and other data points through a web portal.

This “centralized approach” ensures that doctors and care managers can access actionable data in one standard, the Kaiser Family Foundation’s Paradise said in the report. Even if it’s not clinical EHR data, the SDAC platform gives providers a window into their Medicaid patient’ history that they largely did not have before.

For primary care practices in the Medicaid accountable care program, the SDAC also fills in some interoperability gaps. Aside from western Colorado, served by the HIE Quality Health Network, “few systems permit the exchange of data among providers who often serve different areas,” Paradise wrote.

There is some interest is possibly incorporating clinical data from the main HIEs, Quality Health Network and the Colorado Regional Health Information Organization, but one challenge to that would be proving its benefits before investing in that integration. As Paradise wrote, some Colorado health stakeholders “wonder how realistic that might prove to be in their region of the state.”

And other challenges remain within the current scope of Colorado’s data-driven Medicaid policy.

Primary care doctors and care managers using the SDAC data portal can only see information for Medicaid beneficiaries currently enrolled in the accountable care program, leaving record gaps if beneficiaries with fluctuating incomes end up “churning” in and out of Medicaid eligibility.

Another challenge that’s common to pretty much every provider, HIE and health data program in every state is integrating behavioral health data — largely being unable to integrate it, that is.

In Colorado, “current efforts to integrate behavioral and physical health data and care take place against a backdrop of separate payment streams and patient accountability for care in these two spheres,” Paradise wrote.

Regional care collaborative organizations usually have to negotiate agreements to obtain behavioral health data directly with providers. And while the SDAC is empowered to incorporate some behavioral health encounters, in most of Colorado Medicaid behavioral health services are “carved out,” paid for and delivered separate from primary care, and federal law also precludes the sharing of data categories, such as substance abuse treatment.

[See also: Analytics boost N.Y. Medicaid program.]

And then there's the need for federal clarification about behavioral health data. As Kaiser’s Paradise was told by several care managers, “uncertainty and confusion about the kinds of data that may or may not be shared under HIPPA and state law, and with whom, are a barrier.”

Those challenges aside, though, Colorado’s ACO experiment in Medicaid may end up becoming permanent, with all beneficiaries covered under the model, and other states will be looking to the Rocky Mountain state’s experience in crafting their own value-based reimbursement policies in Medicaid.