Transcript Building Blocks to Health Care Reform

Building Blocks
to Health Care Reform
Company
LOGO
Sue Williamson
July 29, 2009
Colorado Health Care Snapshot
Medicare
404
Uninsured
785
8.8%
TRICARE/
Other
111
17.2%
2.4%
Non-Group
157
3.5%
1.2%
Employer
Retiree
54
Medicare &
Medicaid
49
1.1%
Medicaid
Only
346 SCHIP
7.6%
1.1% 53
57.1%
Employer
Workers &
Dependents
2,605
Total Population = 4,564
Source of Insurance
Numbers in Thousands – Source: June 2007 Lewin Report
Colorado Health Care Snapshot
Characteristics of the Uninsured
 70% of the uninsured are in the workforce or are the
dependent of a worker
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 32% of the uninsured have family incomes of $20,000 or less;
13% have family incomes of $75,000 or more.
 40% of the uninsured are between the ages of 19 and 34;
Almost 20% are children
 57% of the uninsured are white
 About $1.25 billion will be spent on Colorado’s uninsured in
2007 – 2008. The uninsured pay for about ½ of their care out
of pocket.
Source: 208 Commission Report – January 2008
The Colorado Promise
 Basic health care should be
available and accessible to all
Coloradans.
 Medicaid must become more
efficient and effective.
 High quality health care should
be available and accessible
regardless of geography.
 We should foster competition
as a means to drive quality up
and costs down.
 Health care for the 180,000
uninsured children should be
an immediate priority.
 We all must take personal
responsibility for our own
health.
 Health care should be
affordable and financed in a
cost-effective manner.
 Health care reform must be
developed collaboratively.
Health Reform Research
208 Commission
Community Forums
 2006 Bi-partisan
Commission created
 Fall of 2007 & 2008
 27 very diverse members
 2007: Focused on the
vision for a stronger
health care system and
the values guiding that
vision
 15 months, 31 proposals,
24 community meetings
 Delivered
recommendations to
Legislature Jan. 31
 Historic, important
 Statewide outreach
 2008: Update on
progress, discussion of
specific strategies
Delivering on the Promise
2007
2008
 Established Preferred Drug
List for Medicaid
 Launched Medical Home pilot
program
 Expanded mental health
benefits in the small group
private market
 Invested in immunizations
 Launched anti-obesity & rural
health initiatives with private
sector partners
 Piloted important disease
management programs
 Expanded CHP+ eligibility*
 Provided Medical Homes for
all Medicaid & CHP+ children
 Began Eligibility Modernization
 Increased Medicaid
reimbursement rates*
 Established CIVHC
 Made Health IT investment
through CORHIO
 Required standard health plan
ID cards
 Established consumer
resource website
2007 / 2008 Results
 $4 million realized savings to Medicaid from the
Preferred Drug List in the first year
 149,000 Medicaid and CHP+ children enrolled in
Medical Homes
 Increases in all categories of primary care
providers accepting Medicaid clients
 Launched DOI consumer Web site
 Promulgated regulations for standard ID cards
 Hired Dori Biester as Interim Director of CIVHC
and appointed board of high profile community
leaders
Delivering on the Promise
2009: CO Healthcare Affordability Act
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Historic legislation – largest health coverage
expansion in 40 years
Cover more than 100,000 uninsured through
Medicaid and CHP+ expansions
 CHP+ to 250% for kids and pregnant women
 Medicaid to 100% for parents and childless adults
 Medicaid buy-in for working disabled
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Reduce uncompensated care and cost shifting by
increasing Medicaid reimbursement to hospitals
Financed through hospital provider fee – commonly
used financing tool; 23 states using hospital fees
Delivering on the Promise
 Strengthen and streamline loan forgiveness programs &
establish Primary Care Office to help rural & underserved
communities (HB 1111)
 Ensure faster, easier transitions to long term care for Medicaid
clients through presumptive eligibility (HB 1103)
 Allow incentives in insurance for voluntary wellness programs
(HB 1012)
 Make it easier for families to navigate Medicaid and CHP+, by
establishing electronic systems for re-enrollment (HB 1020)
 Eliminate the arbitrary waiting period for legally present
pregnant women and children to enroll in Medicaid and CHP+
(HB 1353)
 Requires insurance coverage for the treatment of Autism (SB
244)
Outreach and Enrollment
 Since January 2007

67,000 more children (27% increase) and
23,000 more adults enrolled in Medicaid and
CHP+
 Robust outreach activities

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
Advertising
Community outreach and training
Media relations
Marketing materials development and
dissemination
Outreach and Enrollment
 Novela (Spanish soap opera)


Targeted our Latino families (70% eligible, but
not enrolled in our programs)
Twelve 30 minute episodes that emphasize
family values and weaves primary health care
converns into plot of the stories
 Enrollment Fair Mini-Grant Program

$115,000 ($5,000 grants each) to 23 local
CBOs yielded 700 new enrollments
 Regional conferences and trainings
Pre-Implementation Funding and Technical
Assistance Opportunities
 Colorado has experienced strong local
health foundation support
 Funding from Colorado Trust allowed us to
begin planning for implementation even
before we knew what the policy solutions
were going to be
 SCI opportunity allowed us to meet with
national experts and share information
with other states as we began health care
reform discussions