Denver Post Coverage on Scaling Back Medicaid Expansion

Today's Denver Post covers the recent announcement by the Colorado Department of Health Care Policy and Financing that it will be limiting Medicaid coverage for adults without dependent children. Click here for the article.

Update on State Medicaid Expansion

The Colorado Department of Health Care Policy and Financing has made decisions regarding expanding Medicaid coverage to adults without dependent children, including when and how the expansion will begin and who will be eligible in the first phase. Please click here to read the update provided by The Colorado Coalition for the Medically Underserved's Connect Campaign. 

CMS Creates Medicare Bundled Payment Initiative for Interested Providers

The Centers for Medicare and Medicaid Services (CMS) has invited interested providers to “help test and develop” four different models of bundling payments. Under this initiative, CMS would link payments for multiple services patients receive during an episode of care. Three models involve a retrospective bundled payment arrangement and one model would pay providers prospectively. Nonbinding letters of intent must be submitted by Sept. 22 or Nov. 4, depending on the model that providers plan to pursue. Click here for detailed information on this initiative. 

Policy Brief: U.S. Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions

A new policy brief by the RUPRI Rural Health Center for Policy Analysis examines the trends and regional variations of rural hospital charges due to ambulatory care sensitive conditions (ACSCs), by insurance type, from 2000 to 2004. While ACSC-related charges as a percentage of all charges in rural hospitals decreased by 4.5% during this time period, for uninsured and Medicaid patients the percentage of total ACSC-related charges increased from 12.5% to 15.0%. The authors suggest that investing targeted resources that support ambulatory primary care in rural communities could reduce hospitalizations and associated costs. Click to read the brief. 

The Geography of Need: Identifying Human Service Needs in Rural America

A recent study by the Rural Policy Research Institute, The Geography of Need: Identifying Human Service Needs in Rural America, proposes a new methodology for creating a human service profile based on characteristics of a population and also documents how human service needs differ significantly, in both the degree of need as well as the types of needs, in metropolitan and non-metropolitan counties. The study includes county-level maps that illustrate these characteristics and profiles. Click here to read the report. 

ClinicNET and CRHC Release Patient Centered Medical Home Landscape Brief

Quality care delivered in a Patient Centered Medical Home (PCMH) model involves many different tools, staff, and strategies, including health information technology, health information exchange, and patient registries, to deliver culturally and linguistically appropriate care to patients and their families when and where they need it. ClinicNET and CRHC support the PCMH model and provide services to assist clinics in pursuing PCMH certification or designation. To read the new PCMH brief and to learn more about efforts in Colorado, please click here.

Rural Council Report Focused on Economic Growth

The White House Rural Council released a new report entitled Jobs and Economic Security for Rural America. The report lays out the economic landscape facing rural America and highlights five key areas: creating jobs and promoting economic growth, improving access to quality healthcare and education, fostering innovation, expanding outdoor opportunities, and supporting veterans and military families. Click here to read more and download the report. 

Safety Net Clinic Week is Coming Soon—Are You Ready?

Safety Net Clinic Week is just around the corner, August 22-26. This week is a great opportunity to educate lawmakers and communities about the diversity of Colorado’s safety net. Many rural health clinics and community-funded safety net clinics will be participating by hosting state and federal elected officials to their clinics, holding community open houses, etc. Please click here to access a toolkit that will help clinics that would like to participate. Please contact Alicia or Sara to share what activities you are planning for the week or for assistance.  

Update from CHI on Rural APNs and PAs in Colorado

Colorado Health Institute’s Jackie Colby presented new findings about rural nurse practitioners (APN) and physician assistants (PA) practice patterns at CRHC’s annual conference on Thursday, August 11. The new analysis, based on respondents to CHI’s previous APN and PA surveys, found that about 11 percent of both PAs and APNs work in rural areas yet there are nearly twice as many APNs as PAs overall. Read more.

Dual-eligible Medicare/Medicaid Beneficiaries

Earlier this summer, Colorado received $1 million from the Centers for Medicare & Medicaid Services to plan an integrated model of care for individuals who are dually-eligible for Medicare and Medicaid. A new post from Health Reform GPS gives a detailed summary about some of the challenges in coordinating care for these individuals who are typically older and experiencing multiple chronic conditions as well as provisions in the Affordable Care Act that are intended to address these challenges. Read the post.  

Update on Congressional Deficit “Supercommittee”

The deal reached by Congress and the White House that raised the debt ceiling also called for the creation of a bipartisan Congressional “supercommittee” called the Joint Select Committee on Deficit Reduction. This committee is charged with finding at least $1.2 trillion in savings. These recommendations are due by Thanksgiving, with the entire Congress to vote on them by Christmas to avoid automatic cuts in military and healthcare programs, specifically payments to Medicare providers. Nearly all of the members of this committee have been named. Click here to read about this committee and its members to date.  

Colorado Health Benefit Exchange Board to Hold 3rd Meeting

The next meeting of the Colorado Health Benefits Exchange (COHBE) board will be held this Thursday, August 11th from 9:30 AM – 1:00 PM in the Legislative Services Building (200 E. 14th Ave., across the street from the State Capitol). It has not been determined if the meeting will be broadcast on the web. The by-laws committee of the Exchange Board had a conference call yesterday to discuss legal counsel and the process for developing the by-laws. Committee members Steve Erkenbrack, Ken Lund, and Richard Betts will make recommendations to the Board during its meeting Thursday. The Board is also expected to appoint a Chair. 

Peter Marcus of The Colorado Statesman, a weekly nonpartisan political paper, wrote a great article yesterday detailing the Board’s process so far and some of the controversy surrounding its appointments and funding. Click here to read the article.

For more information on the Colorado Health Benefit Exchange, contact Alicia. 

LGBT Health Survey Available Online

The One Colorado Education Fund has created an online survey to measure the healthcare needs and experiences of lesbian, gay, bisexual, and transgender (LGBT) Coloradans. The anonymous survey is available in both English and Spanish and will be open through August 26. The Survey is an opportunity for LGBT Coloradans, including those living in rural communities, to share their experiences and feedback. Click here to access to survey. Read more. 

Defining Rural: Issue for White House Rural Council?

U.S. Agriculture Secretary and Chair of the White House Rural Council Tom Vilsack said that he would ask the Council to consider streamlining the many existing definitions of “rural” in use among federal agencies. The federal government has 16 agencies with 88 programs that have varying and contradictory definitions of rural America for eligibility purposes. Read more. 

New Report on “Modernizing” Rural Healthcare

A recently released report by the UnitedHealth Center for Health & Reform Modernization examines the health needs of rural America and how well the healthcare system is able to respond. The paper looks at coverage, access, and quality in rural communities and also outlines recommendations for addressing issues including greater use of telemedicine, expanded roles for nurse practitioners and physician assistants, designing regulations to meet the needs of rural areas, and engaging more rural consumers in improving their health. Read more. 

Debt Ceiling Update

Congress and the White House reached a deal to raise the nation’s debt ceiling and avoid default. In addition to increasing the federal borrowing limit, the plan also included substantial deficit reduction measures. The agreement, which operates in two parts, would raise the debt ceiling by $900 billion immediately in August and September and require an equal $900 billion spending reduction.  Medicare and Medicaid would not be impacted by these initial cuts, despite earlier information that Medicare payments to rural hospitals could be reduced by roughly $14 billion and Medicaid matching rates would be lowered. Thank you to all who called or wrote their Members of Congress to express concern about these cuts.

The second component of the debt ceiling legislation creates a 12-member “super congress” made up of equal numbers of members of both parties and both bodies of Congress. This committee would be responsible for making recommendations for $1.2-1.5 trillion in additional savings by Nov. 23. The committee may target Medicare and Medicaid for reductions to achieve these savings. The committee’s recommendations would be subject to a simple up-or-down vote before Dec. 23 and could not be filibustered.  If the recommendations pass, the President could request an additional increase in the debt ceiling of $1.5 trillion. If Congress fails to either act on the committee’s proposal or send a balanced budget amendment to the states before the end of the year, then an automatic “trigger” of across-the-board spending cuts totaling $1.2 trillion would go into effect. The cuts would apply to both mandatory and discretionary spending programs beginning in 2013. Medicaid, Social Security, and veterans’ benefits would not be subject to the cuts, but Medicare provider payments would face a cut of up to 2 percent over nine years (2013-2021). The president would then be authorized to request an additional increase in the debt ceiling of $1.2 trillion.

The agreement passed both the House and Senate and the President is expected to sign it as soon as possible. Click here to read more about the agreement and its potential impact on health programs.