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Thursday, August 30, 2012

GAO Reports on Medicaid Expansion

The United States GAO released "Medicaid Expansion: States' Implementation of the Patient Protection and Affordable Care Act." The report addresses the actions states are taking to implement the Medicaid expansion, what actions selected states have taken to prepare for the Medicaid expansion provisions of the Affordable Care Act, what challenges they have encountered, and states’ views on the fiscal implications of the Medicaid expansion on state budget planning.

SHADAC Report Finds Safety Net Programs Working for Kids

The State Health Access Data Assistance Center (SHADAC) released a report which analyzes recent trends in health insurance coverage for children at the state level between 2008 and 2010. The report found the percentage of children with public coverage through Medicaid or the Children’s Health Insurance Program (CHIP) increased substantially, while rates of private coverage and uninsurance declined. Read more here.

Rules Released for ICD-10 and Meaningful Use

Health and Human Services (HHS) Secretary Kathleen Sebelius announced the release of a rule that makes final a one-year proposed delay in the compliance date for the industry’s use of ICD-10 codes. The ICD-10 codes classify diseases and health problems. The new deadline for the transition is October 1st of 2014. Read the final rule here.

Also released, were the final rules for Stage 2 of meaningful use. The rules are part of a federal incentive program for Medicare and Medicaid physicians to adopt electronic health records and are set to become effective for participants in the program no earlier than 2014. The final rules can be viewed here.

The Hospitality of Rural Hospitals

The Durango Herald writes about the hospitality of a rural hospital. Read the article here.

Thursday, August 23, 2012

Happy Safety Net Clinic Week!

Safety Net Clinic Week (SNCW) is almost over, but the success continues. This week 13 clinics across the state provided tours or hosted an open house to celebrate SNCW. All total, over 200 people visited a Rural Health Clinic (RHC) or a Community-Funded Safety Net Clinic (CSNC). CRHC and ClinicNET would like to thank clinic and hospital staff for taking time out of your busy days to provide tours and host guests.

While we’ve dedicated this week to celebrating these important facilities in the safety net, it’s important to remember they should be celebrated all year long, because despite limited resources, workforce challenges, and low reimbursements, these clinics remain committed to providing high quality, patient-centered, affordable healthcare for their patients and their communities. Thank you for all you do!

Colorado’s Health Care Safety Net: 2012 Primer Released by CHI

This week the Colorado Health Institute (CHI) published, “Colorado’s Health Care Safety Net: 2012 Primer.” The primer provides information about the providers in the safety net, who uses it, and where safety net funding comes from, as well as a list of additional resources and more information regarding the safety net. Click here to read the report.

Webinar: Potential Roles for Safety Net Providers in Supporting Continuity Across Medicaid and Health Insurance Exchanges

Next week the National Academy for State Health Policy (NASHP) is hosting a webinar about the challenge states face supporting continuity of care for individuals and families who may churn between Medicaid and commercial coverage purchased through health insurance exchanges.

As the Colorado Health Benefit Exchange Board works to develop a health insurance exchange where Coloradans can successfully go to compare cost and quality across health plans, determine if they are eligible for Medicaid or for premium tax credits, and purchase coverage, one significant concern remains unsolved. What happens when individuals and families experience changes in income that will cause them to churn (shift eligibility for Medicaid and other subsidized coverage)? Disruptions in coverage have the potential to lead to expensive disruptions in care. Learn more about this challenge and what providers may need to undertake to adapt to the new coverage environment by participating in NASHP’s webinar on Tuesday, August 28th. Click here to register.

73 Colorado Primary Care Practices to Participate in Initiative

The CMS Innovation Center selected 73 Colorado primary care practices to participate in the Comprehensive Primary Care Initiative. The practices represent 335 primary care practitioners serving approximately 41,000 Medicare beneficiaries across urban and rural Colorado.

The Comprehensive Primary Care (CPC) initiative is a multi-payer initiative fostering collaboration between public and private healthcare payers to strengthen primary care. Medicare will work with commercial and state health insurance plans and offer bonus payments to primary care doctors who better coordinate care for their patients. Primary care practices that choose to participate in this initiative will be given resources to better coordinate primary care for their Medicare patients.

Click on the hyperlinks above to see a list of the practices selected in Colorado or to read more about the Comprehensive Primary Care Initiative.

The Accountable Care Organization (ACO) Work Continues

An article in the MedPage Today this week reported the vast majority of hospitals aren’t ready to participate in ACOs (read here). According to the Centers for Medicare and Medicaid Services (CMS), an ACO is, "an organization of healthcare providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it.”

While most hospitals may not be ready to embrace an ACO, there are opportunities to learn more about them and provide feedback on how educational opportunities can be designed. A report published by the Commonwealth Fund published this week examines six shared-savings pilot initiatives and explores the differences in shared-savings approaches, the outcomes they achieve, how to improve them, and whether and how to diffuse them. Read the report here.

On Monday, August 27th from 11:00am – 1:00pm MT, the Center for Medicare and Medicaid Innovation will host an open door forum to solicit input on how educational opportunities for providers interested in participating in ACOs or other coordinated care initiatives could be designed. No prior registration is necessary. Call the number below 5 – 10 minutes before beginning the forum.
Phone Number: (866) 501-5502
Conference ID: 1602701

Wednesday, August 15, 2012

HCPF is Committed to Colorado's Medicaid Accountable Care Organization

The Department of Health Care Policy and Financing released a position statement last month related to the Accountable Care Collaborative (Colorado's version of an Accountable Care Organization for Medicaid clients, rather than Medicare). You can read the statement here, but to summarize, the Department states they remain committed to the ACC as the predominant program that will lead Colorado Medicaid into the future of better health care. The primary goals of the ACC Program are to improve the health of Medicaid clients and reduce costs.

Tricia McGinnis of the Commonwealth Fund wrote a blog post about the emergence of Medicaid Accountable Care Organizations in states and the opportunity these programs have to better serve the most vulnerable low-income populations. Read the blog post here.

Tuesday, August 14, 2012

Learn More About the CO-OP Intended to Improve Coverage in Rural Areas

The Colorado Health Insurance Cooperative, Inc. (CO-OP) was notified last month by the U.S. Department of Health and Human Services that its loan application for $69 million to start and operate a statewide nonprofit health insurance CO-OP was approved. The CO-OP is a Consumer Operated and Oriented Plan, a new kind of nonprofit health insurance company intended to overcome some of the access issues commonly experienced in rural areas by offering affordable, high quality health plans to both rural and urban Coloradans.

The Colorado Health Insurance Cooperative (CO-OP) is sponsored by the Rocky Mountain Farmers Union Educational and Charitable Foundation. Many consumer groups, healthcare provider organizations, another nonprofit health plan, the Colorado Medical Society and the National Federation of Independent Business supported the CO-OP’s loan application process.

Colorado Public Radio reporter Ryan Warner discusses health insurance cooperatives and the efforts to build a member owned CO-OP in Colorado. You can listen to Ryan's interview here to learn more about what this means for Coloradans.

Monday, August 13, 2012

Aging Baby Boomers Face Home Healthcare Challenge

Home health aides can help keep people in their homes who might otherwise need to live in a long term care facility. The U.S. Labor Department projects that home health and personal care aides will be among the fastest-growing jobs over the next decade, adding 1.3 million positions and increasing at a rate higher than any other occupation. However, filling those new home care positions over the next decade will be a challenge to say the least. Read more from Minnesota Public Radio.

Friday, August 10, 2012

Will Anyone See the New Medicaid Patients?

About 69 percent of doctors nationally accept new Medicaid patients, but the rate varies widely across the country. A new study in Health Affairs, detailed in Kaiser Health News, says that in Colorado, slightly less than the national average of doctors agree to take on new patients who are on low-paying Medicaid. The Colorado rate is about 66 percent, just under the national average of 69 percent.

Comments from a Rural Healthcare Leader

Watch a video interview with Todd Linden, President and CEO of Grinnell Regional Medical Center, a 49- bed, private non-profit hospital in Grinnell, Iowa. In the interview. Mr. Linden discusses the differences between running a rural versus an urban medical facility, how technology is affecting rural healthcare, and his hopes for the future of the field.

Should You Celebrate Safety Net Clinic Week? The Answer is Probably Yes!

Is My Clinic A Safety Net Clinic? The answer may not be obvious. If you have ever wondered if your clinic is a safety net clinic, the following survey may help you answer that question.
 
First, does your clinic provide preventive and primary health care services or chronic disease management?
Yes / No
 
If you answered yes to the question above, please read each statement below and determine if the statement is true.  
  • My clinic is a federally certified Rural Health Clinic (RHC).
  • My clinic is located in a health professional shortage or medically underserved area.
  • My clinic offers free or discounted services on a sliding fee scale or as a flat fee.
  • My clinic sees uninsured patients regardless of their ability to pay.
  • My clinic accepts Medicaid, Child Health Plan (CHP), and/or Tri-Care.
  • My clinic participates in the Colorado Indigent Care Program (CICP).
  • My clinic does not accept reimbursements from third-party payers.
  • My clinic utilizes volunteer clinicians.
  • My clinic is eligible for FTCA medical malpractice liability protection.
  • My clinic receives Primary Care Fund dollars.
  • My clinic receives grants, contributions and/or donations.
  • My clinic is part of a Family or Internal Medicine Residency Program.
  • My clinic provides translation services for non-English speaking patients.
  • My clinic receives Section 330 funding (under the Public Health Services Act).
  • My clinic provides Indian Health Services.
  • My clinic receives funding under Title X.
If your clinic provides health care services and the answer to one or more of the options above is yes, then congratulations, your clinic is a safety net clinic! Therefore, the Colorado Rural Health Center and ClinicNET encourage you to consider celebrating Safety Net Clinic Week August 20th through 24th, 2012. SNCW is a week dedicated to raising awareness of all the various types of clinics with a commitment to serving patients who might otherwise have difficulty getting medical care.
 
Why is it important to celebrate Safety Net Clinic Week? Because while safety net clinics have some similarities, they also look very different from one another and it is important to know where, why and how health care is currently being delivered. When it comes time for the federal, state, or even local government to make decisions regarding provider reimbursements, tobacco tax funds, Medicare or Medicaid payments, public coverage program eligibility, electronic health records (EHR) incentives, or other important policy choices, the people making those decisions need to understand how they affect safety net clinics like yours.

The COHBE Board will Submit Grant Application, and Other Updates on the Exchange

The Chair and Vice-Chair of the Legislative Implementation Review Committee gave approval Thursday for the Exchange to submit a second Level One Establishment Grant application to the federal government for activities related to the Exchange. Previously approved by the Colorado Health Benefit Exchange (COHBE) Board, this grant application seeks funds to pay for planning activities, acquisition of technology systems and development of customer service operations necessary to implement Senate Bill 11-200 for the period between October 2012 and July 2013. The application will be submitted prior to the August 15 deadline.
 
Read the other updates on the development of Colorado's Health Benefit Exchange, from the Exchange's Director of Outreach and Communications, below.
  • Patty Fontneau blogs about the next grant application. 
  • The COHBE Board will meet on Monday, August 13, 8:30 am. Information is available here
  • The Individual Experience Advisory Group will meet on Tuesday, August 14, 2:30 pm. Information is available here
  • The SHOP Advisory Group will meet on Thursday, August 16, 10 am. Information is available here.