ALL of the following

• ONE geographic section only (max 70 points)

  • ALL of the following

    • Criteria: At least 50% of members served during the lookback period live in a CEAC (counties with extreme access considerations).
    • Points: 70.
    • Notes: Eligible CEAC counties: Archuleta, Baca, Bent, Cheyenne, Conejos, Costilla, Crowley, Custer, Dolores, Grand, Gunnison, Hinsdale, Huerfano, Jackson, Kiowa, Kit Carson, Las Animas, Lincoln, Mineral, Moffat, Phillips, Prowers, Rio Blanco, Routt, Saguache, San Juan, San Miguel, Sedgwick, Washington and Yuma.

  • ALL of the following

    • Criteria: At least 30% of members served during the lookback period live in a CEAC (same eligible counties as above).
    • Points: 30.

  • ALL of the following

    • Criteria: At least 50% of members served during the lookback period live in a rural county.
    • Points: 30.
    • Notes: Eligible rural counties: Alamosa, Chaffee, Delta, Elbert, Fremont, Lake, Logan, Montezuma, Montrose, Morgan, Otero, Ouray, Pitkin, Rio Grande and Summit.

  • ALL of the following

    • Criteria: At least 50% of members served during the lookback period received care from a brick-and-mortar location within a local Colorado county (local practice).
    • Points: 10.
    • Notes: Eligible local counties listed in policy (includes Alamosa, Archuleta, Bent, Chaffee, Cheyenne, Conejos, Costilla, Crowley, Custer, Delta, Dolores, Eagle, Elbert, Fremont, Garfield, Grand, Gunnison, Hinsdale, Huerfano, Jackson, Kiowa, Kit Carson, La Plata, Lake, Larimer, Las Animas, Lincoln, Logan, Mesa, Mineral, Moffat, Montezuma, Montrose, Morgan, Otero, Ouray, Phillips, Pitkin, Prowers, Pueblo, Rio Blanco, Rio Grande, Routt, Saguache, San Juan, San Miguel, Sedgwick, Summit, Baca, Washington, Weld and Yuma).

ALL of the following

• Applicability: This section applies only to practices that provided at least 20 visits for members during the lookback period.

• ANY of the following

  • ALL of the following

    • Criteria: Practice contains at least one prioritized-specialty provider who provided at least 10 visits during the lookback period.
    • Points: 20.
    • Notes: Prioritized specialties include providers with provider type child psychiatrist, autism service provider, or eating disorder (per credentialing), or providers who completed ≥20 hours training specific to serving members with intellectual and developmental disabilities.

  • ALL of the following

    • Criteria: At least 30% of health care providers in the practice are enrolled with Violet by Dec 31, 2026 (base threshold).
    • Points: 20.
    • Notes: Thresholds increase to 40% for the CY27 lookback and 50% for the CY28 lookback for later SFYs.

  • ALL of the following

    • Criteria: At least 50% of health care providers in the practice are enrolled with Violet by Dec 31, 2026 (enhanced).
    • Points: 10.

  • ALL of the following

    • Criteria (base): By Dec 31, 2026 at least 30% of providers complete their Violet profile and 40% achieve a Violet benchmark (Badge).
    • Points: 20.

  • ALL of the following

    • Criteria (enhanced): Practice completes Violet profile requirements and 60% of providers achieve a Violet benchmark by Dec 31, 2026.
    • Points: 20.

ALL of the following

• Applicability: Includes practices that provided at least 20 visits for members during the lookback period.

• ONE percentage group

  • ALL of the following

    • Prioritized populations: members who speak a non-English primary language, are Hispanic, identify as non-white race, have a social determinant of health need, are or were previously involved in foster care, or have intellectual or developmental disabilities.

  • ALL of the following

    • Prioritized populations: same definitions as above.

  • ALL of the following

    • Prioritized populations: same definitions as above.

  • ALL of the following

    • Prioritized populations: same definitions as above.

ALL of the following

• Total points achieved map to reimbursement percent of base fee schedule for the rate-enhancement period:
• 0 points → No enhancement (Rate = 100% of base fee schedule).
• 1–20 points → Rate = 110% of base fee schedule.
• 21–50 points → Rate = 120% of base fee schedule.
• 51–80 points → Rate = 130% of base fee schedule.
• 81–110 points → Rate = 140% of base fee schedule.
• 111–190 points → Rate = 150% of base fee schedule.

ALL of the following

• Lookback and cohort timing: Lookback period and notification schedule described in policy (e.g., lookback for Oct 1, 2025 entry: Jan 1, 2026–Dec 31, 2026; enhancement notifications noted in policy).
• Applicability: Increased reimbursement applies July 1, 2027–June 30, 2028 and also applies to Medicaid members enrolled in Region 2 operated by Northeast Health Partners.