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Colorado has kicked off a broad medical home project in 17 primary care practices around the state. Those physicians will receive standard fee-for-service, a monthly care management fee and bonuses for meeting or surpassing quality goals, while shifting away from payment for episodic care. To further ingrain the medical home concept, a parallel program will institute patient-centered medical home tenets in the curriculum of the state's 10 residency programs. Aetna, CIGNA, Humana, UnitedHealthcare and WellPoint have all pledged support, as has the Colorado Medicaid program and Cover Colorado, the state's high-risk pool. Colorado Medicaid is poised for sweeping change, now that a new hospital provider fee has become law. The state could cover up to 100,000 more residents, due to streamlined enrollment and childless adults eligible for the first time. However, the economy has impacted the state's small group market, leaving fewer people in that group with health benefits.

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