Final Surge Pushes ACA Enrollment in Colorado

Enrollment for private health insurance coverage for this year ended Monday with a surge that led to 118,628 Coloradans signing up on the state exchange (Connect for Health Colorado). Some 12,000 people signed up during the last week of open enrollment.

Enrollments under the Affordable Care Act are expected to continue to climb over the next few weeks in Colorado. Those who started their applications prior to the deadline, but were unable to complete them, will be given more time.

Connect for Health Colorado reported yesterday (Tuesday) that between Oct. 1st and March 31st, more than 277,000 Coloradans obtained either commercial or public health insurance under the Affordable Care Act. Medicaid gained 158,521 enrollees. The federal program expanded under the law in Colorado to cover lower-income single adults as well as disabled people, mothers, pregnant women and children.

Read the article in the Denver Post here.

The 2014 Colorado Legislative Session Begins Today!

The 69th session of Colorado General Assembly begins today! We’re predicting this may not be a healthcare-heavy session. Implementation is in full swing, so this year we’ll see some clean up bills along with some other small changes. However, given the changes in the composition of the Senate due to the recalls (the Senate is now split 18-17 Democrats, a change from 20-15 Democrats last year), and the fact that this is an election year, there may be some surprises yet. Stay tuned for updates on the budget and other bills impacting rural Colorado from CRHC! Use this link throughout the session to see which bills have an official CRHC position.

Draft of Essential Health Benefits Benchmark Plan Released

The Governor’s Office, Division of Insurance and the Exchange are requesting stakeholder feedback about a draft recommendation for Colorado’s essential health benefits (EHB) benchmark plan. Beginning in 2014, most health insurance plans sold to small employers and individuals must include a minimum set of health care services and products. This set of services and benefits is called Essential Health Benefits. A draft of Colorado’s EHB Benchmark plan can be found here. Comments on this draft should be sent to the EHB email, ehb@dora.state.co.us. After consideration of the comments from stakeholders, the Division of Insurance will release a final recommendation. The deadline for submitting public comment is September 10, and Colorado’s benchmark plan will be chosen by October.

An introduction to the EHB decision making process, a comparison of EHB plans and an FAQ document can be found on the Colorado Health Benefit Exchange website (click here).

ACC Payment Reform Initiative Update

The Accountable Care Collaborative (ACC) payment reform initiative bill passed during the 2012 legislative session allows the Department of Health Care Policy and Financing (HCPF) to accept proposals for innovative payment reforms that will demonstrate new ways of paying for improved client health outcomes for Medicaid clients while reducing costs.

The Department is developing a formal process for requesting, receiving, evaluating and selecting proposals. The first step will be an invitation for abstracts. All abstracts must be submitted through the Accountable Care Collaborative's Regional Care Collaborative Organizations (RCCOs) and their partners. Abstracts will assist the Department in developing the proposal evaluation criteria. Please click here to find a fact sheet, FAQ document and the invitation for abstracts link. There will be an opportunity for stakeholder input during the proposal criteria development phase of the process.

Click here to read more about the process, to find the invitation for abstracts, a fact sheet and FAQs.

Funding for the Old Age Pension Program Renewed

A bill passed during the 2012 legislative session which restored funding for the Old Age Pension (OAP) program. Treatment for the Oral Health Program of OAP is anticipated to begin January of 2013.

The OAP program was established by legislation in 1977 to provide dental care (dentures and related services) to senior citizens who receive Old Age Pension public assistance. To qualify for the OAP Dental Program, an individual must be 60 years or older, live in Colorado, and receive OAP public assistance from the state of Colorado. Interested seniors should contact their individual county department of social services for eligibility information.

The Oral Health Program manages the dental component of the OAP providing grants to eligible grantees for the provision of dental services to seniors eligible for OAP.

Approved procedures and maximum allowable fees are set in the Code of Colorado Regulations (6 CCR 1015-8). Clients may be asked to pay a co-payment not to exceed 20% of the maximum allowable fee.

Click here to read more (scroll down to Old Age Pension Program).

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.

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.

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.

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.

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.

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.

The New “Doughnut Hole” Describes Coverage Gap Created in States Rejecting the Medicaid Expansion

The Supreme Court’s recent ruling on the Affordable Care Act gave governors new flexibility to reject the law’s Medicaid expansion.

States that reject the Medicaid expansion may create a coverage gap being called the new “doughnut hole." Those that fall into the hole will be people who don’t qualify for their state’s current Medicaid eligibility categories nor are eligible for subsidized private insurance in the marketplaces called exchanges. In Colorado, the majority of those folks would be adults without dependent children between 10 and 133% of the federal poverty level (FPL) and adults with dependent children between 100 and 133% FPL. Read the Washington Post‘s article here.

States Should Check with Hospitals Regarding Medicaid Expansion

Hospitals might experience the largest impacts of any type of provider if states decline the opportunity to expand Medicaid eligibility under the Affordable Care Act, so states are being urged to check with hospitals before making the decision to reject the Medicaid expansion. Read more here.

Applications for HB12-1052 Advisory Group Due June 22nd

HB12-1052 charges the Colorado Primary Care Office, in the Prevention Services Division of the Colorado Department of Public Health and Environment, with designating an Advisory Group composed of representatives of "the affected health care professions and individuals with expertise in health care workforce research, analysis and planning." Members of the Advisory Group will serve without compensation or reimbursement for actual or necessary expenses for their participation. The Advisory Group will consider, but is not limited in using, the Division of Registration's existing data fields as a structure for a robust statewide health care license data collection and reporting system including:

1. Each practice address of the health care professional;
2. The number of hours the health care professional provides direct patient care at each practice location;
3. Any specialties of the health care professional if applicable;
4. Information about each practice setting;
5. The health care professional's education and training related to his or her profession and;
6. The year of birth of the health care professional.

This link will take you to an electronic nomination form which, when completed, will transmit directly back to the Primary care Office. The Primary Care Office kindly asks for your assistance in distributing this email through your networks, clinics, facilities or contacts. You are welcome to self nominate as well. The Primary Care Office will begin reviewing completed nomination forms on June 22nd. The Advisory Committee will meet several times beginning in late July and intend to complete the work as quickly as possible and do not expect more than a few months of total effort.

Additional information regarding the scope and intent of HB12-1052 including the Advisory Group is available here.

Colorado Health Benefit Exchange Board Accepting Nominations for Work Groups through Close of Business TODAY

On April 23^rd the Colorado Health Benefit Exchange (COHBE) Board voted to move forward with creating advisory groups.  Applications for the advisory groups must be received by close of business today.  Nominations can be offered by Board members, organizations and interested individuals.  Advisory groups will be composed of approximately 15 – 20 members and will meet on a regular basis.  The advisory groups will begin meeting in late May/early June, and call in options will be available for those that are unable to attend in person. 

A list of the advisory groups and their description are listed below.      

1.      Small Business Health Options Program (SHOP) Advisory Group

This Advisory Group will inform the business processes, tools, and support functions available in the Small Business Health Options Program.

2.      Individual Experience Advisory Group

This Advisory Group will work to maximize the quality of the consumer shopping experience on the individual exchange.  This group will inform the way COHBE handles appeals from consumers and appropriate ways of notifying consumers about changes to their insurance status.  The role of individuals who will assist with providing Exchange services will also be addressed by this group. 

3.      Health Plan Advisory Group

This Advisory Group will inform the business processes, approach and technology needed to support balanced and successful working relationships between COHBE and carriers offering health plans on the Exchange. 

4.      Communications and Outreach Advisory Group

This Advisory Group will help to define the approaches and initiatives that will be used to educate consumers about the value of having insurance; educate customers about the services provided by COHBE; and, help to determine the most effective tools needed to assist COHBE customers in the choice of a health plan that best meets their needs.

Visit the Colorado Health Benefit Exchange website for more information and to sign up for a group today.   

Improvement in Colorado's Revenue Forecast Impact FY12-13 Budget

On March 19^th the Legislative Council (nonpartisan research staff of the CO General Assembly) released the latest economic and revenue forecast for Colorado.  Staff reported that the economy continues to gain strength.  The Fiscal Year 2011-12 General Fund budget is in balance, and an estimated $256 million left in the General Fund at the end of the year above the required reserve.  This is $108 million higher than the amount expected in December.  Click here to read the report. 

The budget-balancing package is expected to be introduced in the House next week.  Part of the proposed budget for FY 12-13 is the Senior Homestead Exemption, which exempts 50 percent of the first $200,000 of a home’s assessed value.  Voters approved the tax break in 2000, but the amendment allows the legislature to zero out the tax break if necessary.  Lawmakers have elected to zero out the tax break in all but four years since it was passed.   However, in light of the latest revenue forecast, the Joint Budget Committee said the state revenues are sufficient to restore the Exemption.  To get the benefit, a senior must be at least 65 years old and have lived in their home for the last 10 years. 

Nominate Yourself to Participate in TBD Colorado

TBD Colorado is a nonpartisan, collaborative effort designed to generate informed and constructive conversations among Coloradans about some of the biggest issues facing the state.  Regional meetings will be held around the state beginning in April and will cover education, transportation, healthcare, state budget, state workforce/talent, higher education and P12 education.  In order to participate in these meetings, you need to have someone nominate you or nominate yourself.  Visit the website to learn more and to find the nomination form. 

Colorado Receives Grant for Health Benefit Exchange

Health insurance exchanges are online marketplaces for individuals and small businesses to compare plans that are similar in benefits for cost and quality and determine whether they are eligible for tax breaks.  Consumers will be able to go online for assistance and to get enrolled. 

Colorado received a Level I establishment grant in the amount of $17.9 million for the Colorado Health Benefit Exchange.  The Exchange will open for enrollment on October 1^st of 2013 and coverage will begin January 1^st of 2014.  Check out the Colorado Health Benefit Exchange website to follow developments or contact Alicia for more information. 

Weekly Bill Tracker

Check out our bill tracker to see which bills CRHC is reviewing or has taken a position.