Understanding the Rise in Health Insurance Premiums

A survey released earlier this week found that employer-based health insurance premiums increased by 8 and 9 percent for single and family coverage respectively from 2010 to 2011. A new analysis by the Commonwealth Fund looked at the potential causes of the increase, including the 2010 insurance reforms included in the Affordable Care Act. The analysis finds 1.8 percent increase could be attributable to the insurance reforms. Read more.

October 3 Deadline to Register, Update Voter Registration

If you would like to vote in this November’s elections, you have until October 3 to register or make changes to your existing registration. Click here for more information and resources from the Secretary of State’s office. 

Federal Budget Update and Upcoming Webinar

Although much attention is being directed to the deficit reduction proposals and work of the President and Super Committee, the federal fiscal year 2011 ends on September 30 and none of the FY 2012 appropriation bills have been enacted by Congress. To avoid a government shutdown on October 1, Congress has been working on a Continuing Resolution that would keep programs funded. After some concerns that the two chambers would not reach a compromise, an agreement was reached yesterday evening that should keep the government operating. This Continuing Resolution does include spending reductions from FY 2011 levels that were agreed upon during deficit reduction negotiations earlier this summer.

The Senate did complete its markup of the FY 2012 Labor-HHS Appropriations bill last week, recommending level funding for many rural health programs including SHIP and Flex. The House has not completed its work on the Labor-HHS bill and it’s not clear whether Congress will pass the spending bills or wait for the Super Committee’s recommendations that are due on November 23.

Want to learn more about the current federal budget negotiations? CRHC, in partnership with the Area Health Education Centers, will be hosting a webinar on October 4 from 2:00-3:00 pm to discuss the issues, how they might impact rural providers and communities, and provide information and resources for communicating with your elected officials. Click here to register for the webinar. 

Update on Affordable Care Act—Could Be Heard by Supreme Court in 2012

The Obama Administration did not request a review by a federal appeals court on a recent ruling on the Affordable Care Act (ACA), making it more likely that the Supreme Court would hear the case later this fall and issue its decision in 2012. With split decisions coming from the appeals courts, the Supreme Court is widely expected to render the final word on the constitutionality of provisions within the ACA. Read more. 

Don't Forget to Complete Our Annual Survey!

Thank you to everyone who has already completed CRHC's annual survey! The survey will close on Friday, September 30 so please take a few minutes today to share your thoughts and feedback on our policy and advocacy work.  

Webinar on Colorado's Medicaid Expansion

Colorado’s Department of Health Care Policy and Financing is hosting a webinar on Tuesday, Sept. 27, 2011, from 3:00-5:00 p.m. MT to discuss the Adults without Dependent Children expansion and the proposed 1115 Demonstration Waiver which will be submitted to the Centers for Medicare & Medicaid Services in the fall of 2011. Click for more information or to register.

Proposed Changes to CHP+

The Medical Services Board is proposing new cost sharing requirements for the Children’s Basic Health Plan (CHP+). As outlined in the proposed rules released on Monday, the annual enrollment fee for families with incomes between 200 and 250% of the federal poverty level would be $75/ year for one child and $105/ year for two or more children. The proposed rules would also increase co-payments based on family income. The initial approval date and public comment hearing on these proposals is October 14. Please click here for more information about the meeting and contact Alicia Haywood if you have any questions or feedback. 

Cutting Healthcare Providers Also Impacts Patients

An article in today’s New York Times highlights the impacts that cuts to healthcare providers can have on patients. 

September Revenue Forecast

Colorado’s economic growth has slowed over the summer, according to today’s revenue forecasts released by the Office of State Planning and Budgeting and the Colorado Legislative Council. The state economy faces many national and global threats; however, agriculture and oil prices are strong. The state’s current FY 11-12 budget is in balance, with a $64 million projected surplus. For FY 12-13, forecasters projected a surplus of approximately $370 million, assuming that the current year’s surplus is rolled over and the economic outlook remains steady. Given this minimal projection for the next year and annual increases in demand for services including Medicaid, spending reductions are expected for the coming year. Read more. 

White House Releases Deficit Reduction Proposal Calling for Medicare, Medicaid Changes

The White House proposal that was released today calls for reducing the nation’s debt by $3 trillion over the next ten years. The deficit reduction plan puts forth significant reductions in Medicare and Medicaid spending that will drastically impact rural healthcare providers and communities, including lowering Critical Access Hospital (CAH) reimbursement, eliminating CAH designation for any facility within 10 miles of another hospital, lowering the federal matching rate for Medicaid to the states, and reducing the Medicaid Hospital Provider Fee. As Congress moves forward with deficit reduction activities in the coming weeks, this proposal will be under consideration. Members of Congress need to hear from their constituents about the impact these cuts will have on rural providers and access to care in rural communities. CRHC will be providing additional information, resources, and opportunities to communicate with your elected officials in the coming days. Read NRHA's response to the White House proposal. 

Latest Estimates of Colorado’s Uninsured

Earlier this month, the U.S. Census Bureau released information on Americans’ income, poverty, and health insurance coverage for 2010. Nationally, median household income declined and the poverty rate increased. While the number of Americans without health insurance increased, the overall percentage was not statistically different from the previous year. The Colorado Health Institute (CHI) released a report on state-level findings, noting that Colorado was the only state that recorded a statistically significant decline in the number of uninsured individuals between 2007-08 and 2009-10. Read CHI’s report. 

Community Paramedics Responding to Community Needs

Today’s New York Times features an article on community paramedics, highlighting Eagle County’s program. Read more. 

Deadlines Extended for Medicare Bundled Payment Initiative

The CMS Innovation Center has extended the deadlines for letters of intent and applications for its Bundled Payments for Care Improvement initiative (BPCI) released on August 23rd. Letters of intent for BPCI Model 1 are now due on October 6th, 2011. Applications for BPCI Model 1 are now due on November 18th, 2011. Read more. 

Loan Repayment Application Cycle Opening

Do you have a healthcare provider at your rural facility who is interested in loan repayment? Let them know that the Colorado Rural Outreach Program Loan Repayment Program application cycle is opening in October. Read more.

Nearly Half of Office Based Physicians Working With NPs and PAs

The Centers for Disease Control and Prevention's National Center for Health Statistics reported in an Aug. 17 data brief that 49% of physicians working in office settings work with nurse practitioners, physician assistants, and certified nurse midwives. Primary care practices were the most likely specialty to work with these practitioners. Read more. 

Complete CRHC's Policy and Advocacy Survey Today

Please inform the Colorado Rural Health Center’s (CRHC) policy & advocacy efforts for 2012 by completing our annual survey. Your feedback is invaluable and will help guide our work. The survey should take approximately 5 minutes to complete and can be accessed by clicking here. The survey will be open until Friday September 30, 2011. Please complete the survey only once. Your responses are greatly appreciated!

New Health Information Technology Website Available

The Office of the National Coordinator for Health Information Technology has launched a new website www.HealthIT.gov. The website has information and resources for both healthcare consumers as well as providers. The site also addresses privacy questions regarding electronic health records. 

Nonfinancial Barriers and Access to Healthcare

A recent study found that more U.S. adults postpone or go without medical care for nonfinancial reasons than for financial ones. Although affordability issues did limit access to care, nonfinancial barriers including availability and accessibility of care often overlapped with financial barriers. Read more.

Community Paramedics Meeting Healthcare Needs in Eagle County

Read more about The Community Paramedic Program, a pilot project through the Western Eagle County Ambulance District, that partners paramedics with physicians to provide in-home health monitoring and check-ups. The program is an innovative solution to some of the challenges of providing healthcare in rural communities.

The Budget Control Act of 2011: Implications for Medicare

A new brief by the Kaiser Family Foundation, The Budget Control Act of 2011: Implications for Medicare, provides an overview of the new law that came out of this summer’s negotiations on raising the debt ceiling and deficit reduction, including a timeline and process for raising the debt ceiling and lowering the federal deficit. The brief also describes the role of the new Joint Select Committee on Deficit Reduction, aka the “Super Committee”, examines how Medicare spending could be affected by changes proposed by the Committee, or if that process fails, by sequestration. Click here to read the brief. 

New Website Available to Answer Questions, Provide Information on Health Insurance

The Colorado Division of Insurance has created a new website for consumers and business owners to answer questions and provide information about health insurance, including what drives the cost of insurance premiums, how to select a plan, and how to get help when an insurance claim is denied. Click here to access the website or go to www.askdora.colorado.gov and click on the “Are You Prepared for Changes in Health Insurance?” button.

New Critical Access Hospital Data Initiative

Rural healthcare providers and advocates know that rural health is not ‘a smaller version’ of urban healthcare systems and that current national measurement and benchmarking systems may not accurately capture and reflect the quality work of rural health providers. The Medicare Beneficiary Quality Improvement Project (MBQIP) is a three-year, voluntary initiative for Critical Access Hospitals (CAH) intended to create a national database of rural appropriate and relevant quality data to demonstrate to policymakers the work CAHs are doing. CAHs that participate in MBQIP will be able to share best practices among one another and be benchmarked against other CAHs across the nation. As Medicare moves toward payment tied to quality and public reporting, MBQIP provides an opportunity for CAHs to prepare for future changes. 

MBQIP’s first of three phases begins in September 2011. To learn more, watch the short MBQIP video on YouTube and contact Jen Dunn or Michelle Mills for additional information.