Health Insurance Exchange Focus Groups

Health Insurance Exchanges are online marketplaces where consumers can shop and buy health insurance products in the independent and small business markets.  Given the high number of ranchers, farmers and small business owners in rural areas, it is crucial the experiences and ideas of rural Coloradans are heard in order to ensure the Exchange works for residents from all parts of the state.  The Colorado Center on Law and Policy is hosting focus groups around the state to better understand the consumer needs, opinions and perspectives of the Exchanges.  This is a great opportunity to provide the rural voice in the process.  A list of the meetings outside the Denver-metro area is below. More information can also be found at Colorado Insurance Exchange Focus Groups.

 

Grand Junction

Dates: August 1st and 2nd

Time: 6-8 pm

Place: Mesa County Workforce Center

Sterling

Date: August 8

Time: 6-8pm (room reserved 5.30 to 8.30)

Place: CSU Extension Room

Address: 508 S. 10th Avenue

Greeley

Date: August 1st

Time: 6-8pm (room reserved 5.30 to 8.30)

Place: Centennial Park Library

Address: 2227 23rd Avenue

Pueblo

Date: August 3rd

Time: 6-8pm (room reserved 5.30 to 8.30)

Place: Rawlings Library (Thurston Room)

Address: 100 E. Abriendo Ave

IOM Report on Improving Access to Oral Health Care

Underserved communities and populations, including rural areas, experience significant access barriers in obtaining oral health care. The Institutes of Medicine (IOM) recently released a report “Improving Access to Oral Health Care for Vulnerable and Underserved Populations” that assesses the current oral healthcare system and recommends strategies for improving access to oral health care. Read more. 

Colorado Health Benefit Exchange Board Holds Second Meeting

The Colorado Health Benefit Exchange (COHBE) Board held their second meeting on Monday, July 25th. Much of the discussion centered around the Board's operations. A summary of the key discussions is below:

Work Groups – The members of the board will participate in the workgroups which best fit their skill set and expertise.

Adoption of By-laws – A small group was formed to look into the by-laws and explore options for private council.  A working outline of the by-laws has been created; the small group will revise them, based upon recommendations from other board members, and bring them back to the full board for review.

Election of Chair and Vice-Chair – A relationship with legal council should be established before adopting the by-laws, which will include the charter for the Chair and Vice-Chair.  Upon adoption of the by-laws, the Board will appoint a Chair and Vice-Chair.  Three members have expressed interest in serving in those positions.

Interim Rules of Operation – The Board discussed the rules of operation to be used prior to the adoption of the by-laws.  Two suggestions were made as revisions to the current rules; the threshold for a board quorum will be increased to six (from three), and the search for the Executive Director will be included in the public meetings. 

Conflict of Interest – The Board discussed whether or not their position could prevent them from serving on other boards.  This will be addressed in the by-laws, but for now the Board agreed disclosure is critical.

Report from Data and Advisory Workgroup (DAWG) – DAWG is working with the Wakely Consulting Group to model the characteristics of the consumers purchasing in the Exchange, model their purchasing habits and estimate the cost of providing their coverage.

 

Meeting Logistics – The Board is looking for a permanent meeting location and standing meeting time.  Due to the travel distance for some members and the amount of work to do, the length of the meetings will be extended to four hours. 

The Colorado Health Institute is convening a variety of workgroups related to the Exchange.  For more information on the Data and Advisory Workgroup (DAWG), the Marketing, Enrollment and Outreach Workgroup (MEOW), the Eligibility, Verification and Enrollment (EVE), and the Small Employer Workgroup (SEWG), visit CHI’s website.  CRHC encourages rural residents to participate in these work groups in order to ensure the rural voice is heard as the Exchange is developed.  Please contact Alicia Haywood of CRHC if you have questions or would be interested in participating.

The next

The next meeting will be held August 11^th from 9:30 – 10:30 AM in the Legislative Services Building across from the Capitol.

CMS Hosting ACO Accelerated Development Learning Session, September 15-16 in San Francisco, CA

The Centers for Medicare & Medicaid Services (CMS) is offering free Accountable Care Organization (ACO) Accelerated Development Learning Sessions to provide executive leadership teams from existing or emerging ACO entities the opportunity to learn about essential ACO functions and ways to build capacities needed for ACOs. The second Accelerated Development Learning Session will be held in San Francisco, CA on September 15-16. Click here for more information and to register. 

Safety Net Clinic Week, August 22-26-Clinic Toolkit Now Available

The second annual Safety Net Clinic Week is August 22-26, 2011.The week will be devoted to educating the public and policy makers about often overlooked providers, Community Funded Safety Net Clinics (CSNCs) and federally certified Rural Health Clinics (RHCs), that care for uninsured and underinsured Coloradans. 

A toolkit of resources is now available for clinics that would like to participate in Safety Net Clinic Week activities. Click here for the toolkit. Please consider hosting an open house or legislative visit at your clinic during the week. Contact Alicia or Sara for more information on how you can get involved with Safety Net Clinic Week. 

Update on Federal Deficit Reduction Negotiations

The bipartisan “Gang of Six” in the U.S. Senate has put forward a plan for deficit reduction. Reports have stated that the deal, totaling $3.7 trillion over 10 years, would include 26 percent revenue increase and 74 percent spending cuts. Early information shows a possible $200 billion in cuts to health care. The released information, however, does not include the specifics of where these cuts would be made. Earlier proposals have included reducing or eliminating the Medicaid Hospital Provider Fee, $14 billion in Medicare cuts to rural providers, and reducing the federal matching rate for Medicaid to the states.

Because the details the health care cuts under consideration are still unknown, it is critical to continue communicating with our members of Congress, especially Senators Bennet and Udall. Please contact Senator Bennet, Senator Udall, and your Representative with this message: “Please protect Medicare and Medicaid as you consider changes and cuts in the federal budget. Rural communities rely on these programs and significant cuts will threaten access to care and economic growth in rural Colorado.” Feel free to personalize your message with how Medicare and Medicaid impact your community. Thanks to all who have already contacted your elected officials.

You can contact your legislators by phone and email: 

Senator Michael Bennet, 202.224.5852 

Senator Mark Udall, 877.768.3255 

Capitol Switchboard, 202.224.3121 (ask for your Representative's office and to speak with the staff who handles health issues)

Click here for a list of Colorado's members of Congress and email addresses for their healthcare staff. If you don't know who represents you in Congress, click here and enter your zip code.

CMS Releases Proposed Rules for Health Insurance CO-OPs

The Centers for Medicare & Medicare Services (CMS) proposed rules regarding the creation of Consumer Operated and Oriented Plans (CO-OPs), private non-profit, consumer-governed health insurance plans. These new plans could get seed money to increase competition under the new rules announced by the Department of Health and Human Services. Read more. 

Colorado HealthStory Holds Its First Community Forum

Last night, Colorado HealthStory, a project of the Colorado Rural Health Center, the Colorado Coalition for the Medically Underserved and ClinicNET, held its first community forum in Aurora.  After collecting stories in Aurora for two months, Colorado HealthStory staff convened community members for a local forum and listening session.  The forum was attended by storytellers, city officials, community activists and the media.  During the forum, attendees listened to some of the stories collected in Aurora, shared issues related to health and discussed key health data specific to Aurora, as well as identified local efforts to address these issues.  The next community forum will be held in Summit County, followed by Rocky Ford, both later in the summer.

In tandem with its first forum, the website for Colorado HealthStory was launched yesterday at www.coloradohealthstory.org.  There, visitors can find out more about the project, hear the stories and find out when HealthStory will be in their community.  As well as visiting the website, Colorado HealthStory can be found on Facebook and followed on Twitter, and videos can be viewed on Vimeo.  

The Colorado Health Benefits Exchange Board of Directors Appointed and Holds First Meeting

Governor Hickenlooper announced the appointments to the Colorado Health Benefits Exchange Board on June 29^th.  Click here to view the press release and Executive Order.  The first meeting of the Board of Directors was held Monday, July 11^th and was well attended by consumer advocates and business representatives.  The next meeting is scheduled for July 25^th.  CRHC is actively participating in the development of the Exchange by attending the board meetings, taking part in the workgroups and monitoring the Legislative Oversight Committee, as well as identifying opportunities to provide input and expertise on behalf of rural Coloradans.  For more information on the board meetings and workgroups, visit the Colorado Health Institute’s website.  For questions regarding the Exchange or activities related to its creation, contact Alicia Haywood. 

County Health Comparisons-Rural Losing Ground

A recent analysis of the County Health Rankings found that Americans residing in major cities live longer, healthier lives overall than rural Americans—a reversal from decades past. Rural residents face higher rates of health issues including diabetes, stroke, heart attack, and high blood pressure. Limited access to care is cited a factor contributing to these growing health disparities in rural areas. Read more.

Comments on USDA Rural Development Needed

The USDA Rural Development is accepting written comments from stakeholders about rural development priorities for President Obama’s 2013 budget and 2012 Farm Bill principles. USDA Rural Development funds programs that are critical to rural counties such as rural water/wastewater infrastructure, community facilities, hospitals and clinics, broadband expansion, housing, renewable energy and business development initiatives.  This is an important opportunity to share insights about how Rural Development can enhance its program administration and delivery to rural counties. The ‘bricks & mortar’ funding available through Rural Development plays a key role in supporting and expanding rural communities here in Colorado and across the nation.

Click here for more information and questions that USDA would like feedback on from the public. Although no firm deadline has been established, comments are preferred by the end of July and can be emailed directly to USDA. 

CO-OP Health Plans & Rural Health Insurance Markets

A recent report assesses the opportunities and challenges of using the Consumer Operated and Oriented Plan (CO-OP) program in federal health reform to address the limitations of the rural private health insurance market. Download the report. 

Flex Monitoring Team Responds to JAMA Article on Quality of Care at CAHs

The Flex Monitoring Team, the nation's leading experts on rural health care quality, has prepared a detailed analysis of last week's article in JAMA on quality of care at critical access hospitals (CAH). The JAMA article concluded that compared with non-Critical Access Hospitals (CAH), CAH’s had fewer clinical capabilities, worse measured processes of care, and higher mortality rates for patients with AMI, CHF or pneumonia. “The report is simply deficient when it comes to understanding the basic role of a Critical Access Hospital within a rural community,” said Alan Morgan, National Rural Health Association CEO.  “The current quality measurement systems available do not adequately reflect the core work of what rural hospitals do on a daily basis.”

Funded by HRSA, the Flex Team has provided detailed national and state reports on CAH quality for the past six years. Their numerous reports document the substantial progress in quality improvement that CAHs have made during that time frame, as well as areas in which there is still room for improvement. Click here to view the Flex Team's response to the JAMA report.

CRHC has been working with the 29 CAHs in Colorado for over 10 years on quality improvement activities including the Quality Network, 100,000 Lives Campaign, 5 Million Lives Campaign, Quality Health Indicators (QHi) Benchmarking, and iCARE (Improving Communication & Readmission). For more information on CRHC’s CAH quality improvement programs, contact Jen Dunn, CAH Program Manager.

Call to Action: Contact Your Member of Congress & U.S. Senators Today

As has been mentioned in previous posts, political leaders in Washington are discussing options for raising the nation’s debt ceiling limit by August 2^nd and cutting federal spending to address the deficit. Medicare and Medicaid are under consideration for substantial spending cuts, including reducing the federal Medicaid matching rate to the states, and limiting or eliminating the Medicaid hospital provider fee that supports expansion of coverage to the uninsured and the hospitals that care for the medically vulnerable.

As you know, Medicare and Medicaid are essential to rural healthcare providers and communities. The proposed cuts will severely compromise access to healthcare for rural residents and hamper local economies that depend on healthcare providers for jobs and economic development. Colorado’s Congressional delegation needs to hear from you about the importance of Medicare and Medicaid to rural Colorado. Please take five minutes today or no later than Wednesday July 13 to contact Senator Bennet, Senator Udall, and your Representative with this message: “Please protect Medicare and Medicaid as you consider changes and cuts in the federal budget. Rural communities rely on these programs and significant cuts will threaten access to care and economic growth in rural Colorado.” Feel free to personalize your message with how Medicare and Medicaid impact your community. 

You can contact your legislators by phone and email: 

Senator Michael Bennet, 202.224.5852

Senator Mark Udall, 877.768.3255

Capitol Switchboard, 202.224.3121 (ask for your Representative's office and to speak with the staff who handles health issues)

Click here for a list of Colorado's members of Congress and email addresses for their healthcare staff. If you don't know who represents you in Congress, click here and enter your zip code.

Thank you for your calls and emails. Please contact Sara if you have any questions and we will post updates on the budget negotiations as they are available.  

 

Emergency Department Visits in Rural and Non-Rural Communities

A new statistical brief by the Agency for Healthcare Research and Quality compares emergency department (ED) visits in rural and non-rural communities. Rural ED visits were more likely to be billed to Medicare, Medicaid, or no payer than in non-rural communities. Also, fewer ED visits in rural communities resulted in hospital admissions. Read the report for additional information.  

States Cutting Medicaid Rates, Healthcare Programs At Risk in Budget Negotiations

Several states, including Colorado, began their fiscal years on July 1 by reducing Medicaid payment rates to providers and hospitals. A Kaiser Health News report outlines various states’ changes in Medicaid, including payment and benefit reductions, that may further compromise access to care for Medicaid recipients.

In Washington, Medicaid and Medicare program cuts are under consideration as political leaders negotiate budget and debt issues. Negotiators are discussing serious reductions in Medicaid, including reducing the federal matching rate to the states and limiting or eliminating the Medicaid hospital provider fee that both supports Colorado’s coverage expansions to the uninsured and our hospitals that care for the un- and underinsured. Negotiations are expected to continue for the next several weeks as the national debt ceiling limit approaches on August 2^nd. Given the critical role that Medicare and Medicaid play in rural communities, CRHC has been communicating with Colorado's members of Congress about these issues and will be sharing opportunities for you to contact your member directly in the coming days. Please contact Sara if you have any questions.  

Life Expectancy Declines For Some of Colorado's Rural Communities

A new study by the University of Washington featured in the Denver Post found that from 1997-2007 life expectancy decreased for women in several rural counties on the Eastern Plains. Overall, life expectancy in many rural, non-mountain resort counties is relatively lower. Read more.