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. 

Governor Hickenlooper Announces Appointments to the Colorado Health Benefits Exchange Board

Governor Hickenlooper announced the appointments to the first Colorado Health Benefits Exchange Board today.  “This will be a Colorado-based health exchange that is created by Coloradans, for Coloradans,” said Hickenlooper. “The Exchange represents a broad collaborative effort between businesses, consumers, providers, the insurer community and the state legislature.  We are excited to be a leader among states on this issue, and one of 10 states that passed legislation.”

The Exchange will be governed by nine voting board members and three ex-officio members.  The members appointed by the Governor, Senate and House Majority and Minority leadership are:

• Richard T. Betts of Telluride, with a term to expire 2013.  Betts is the owner, ASAP Accounting & Payroll, Inc.
• Eric Grossman of Englewood, with a term to expire 2013.  Grossman is a vice president of TriZetto.
• Robert S. Ruiz-Moss of Lone Tree, with a term to expire 2013.  Ruiz-Moss is the Chief Executive Officer of Anthem Blue Cross.
• Elizabeth Soberg of Centennial, with a term to expire 2013.  Soberg is the Chief Executive Officer of UnitedHealthcare of Colorado.
• Gretchen Hammer of Denver, with a term to expire 2015.  Hammer is the Executive Director for the Colorado Coalition for the Medically Underserved.
• Stephen ErkenBrack of Grand Junction, with a term to expire 2015.  ErkenBrack is the president of Rocky Mountain Health Plan.
• Arnold Salazar of Alamosa, with a term to expire 2015.  Salazar is the Executive Director of Colorado Health Partnerships, LLC.
• Nathan Wilkes of Arapahoe, with a term to expire 2015.  Wilkes is the founder and principal consultant, Headstorms, Inc.
• Dr. Michael Fallon of Denver, with a term to expire 2015.  Fallon is an emergency room physician

The Colorado Health Exchange was created by Senate Bill 11-200.  It will be an independent public entity not affiliated with an existing state agency or department and initially funded by gifts, grants and donations.  The first meeting of the Exchange Board will be held on Monday, July 11^th.  CRHC will be monitoring the activities of this board, particularly as it pertains to access and affordability for rural Coloradans. 

Recent Changes in Health Insurance Coverage in Rural and Urban Areas

A report by the Rural Health Research & Policy Analysis Center compares changes in health insurance coverage for non-elderly Americans in rural areas to changes in urban areas during the recent economic recession from 2007 through 2009. In general, rural and urban areas were equally affected by shifts away from private coverage and towards public coverage and uninsurance between 2007-2009; however, rural residents continued to be less likely to have private coverage and more likely to have public coverage than their urban counterparts. Read more. 

Addressing Colorado’s Primary Care Physician Shortages

An article in the Colorado Springs Gazette discusses the current shortage of primary care physicians in rural areas that is projected to worsen in the coming years. The article highlights the clinical team in Rocky Ford & Ordway, including a full time nurse practitioner and part time, traveling family physician, who are meeting the healthcare needs of their communities. Read more. 

CRHC Accepting Nominations for Rural Health Excellence Award

CRHC is now accepting nominations for the 2011 Rural Health Excellence Award. This prestigious award is given annually by Colorado Rural Health Center to honor those who have made a notable contribution to health, healthcare, or a healthcare delivery system in rural Colorado. For 2011, the award will be presented during the 20th Annual Colorado Rural Health Conference August 11-12th, at the Denver Tech Center Hyatt Regency.

To be eligible for the award, a candidate must have made a significant contribution to the health, healthcare, or a healthcare delivery system in a rural Colorado community, area, or region. Healthcare providers, board members, administrators, volunteers and others are eligible for nomination. Despite their enormous contributions, CRHC Board Members are not eligible for nomination while serving on the Board.


To nominate someone, complete the entry form. The deadline for nominations is July 15, 2011.Contact Nadine Gressett with questions. 

National Prevention Strategy Released

The nation’s first National Prevention and Health Promotion Strategy (National Prevention Strategy) was released last week by U.S. Surgeon General Regina Benjamin, MD. The Strategy’s goal is to increase the number of Americans who are healthy at every stage of life and provides strategic directions and priorities to address health disparities and create healthier workplaces, schools, and communities. Read more. 

June Revenue Forecast

The Governor's Office of State Planning and Budget released its June revenue forecast for General Fund revenue, estimating an increase in revenues by $78.1 million compared with the March 2011 forecast. Although citing some positive economic developments, the forecast projects flat revenues for FY 11-12 and estimates a shortfall of $22.4 million in the coming year to maintain a four percent reserve requirement. Modest economic growth is not expected until FY 2012-2013. Read more.

Safety Net Clinic Week is August 22-26, 2011

In efforts to raise awareness of Colorado's healthcare safety net providers and clinics, ClinicNET and the Colorado Rural Health Center are sponsoring the second annual Safety Net Clinic Week on 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. 

There are currently 33 identified CSNCs in Colorado. These clinics tend to be non-profit, rural & urban, and privately funded and they provide primary care services to uninsured and underinsured individuals. Colorado has 52 federally certified RHCs that provide primary care services in some of the most rural and remote areas of Colorado. 

We will be posting more information on Safety Net Clinic Week, including ideas and resources to assist clinics that would like to participate. If you work at a CSNC or RHC and are interested in hosting a site visit with policy makers, we are here to help and will have more information coming soon. 

New Medicare Advantage Policy Brief

Roughly one in four of the nation’s 47 million Medicare beneficiaries currently participate in Medicare Advantage. A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation explains how Medicare Advantage plans work, how they are different from traditional “fee-for-service” Medicare, ways in which the plans will change under provisions in the Affordable Care Act, and the debate over the possible effects on the plans. Click here to read the brief. 

ACA Provisions to Strengthen the Nursing Workforce

The Affordable Care Act (ACA) contains many provisions related to healthcare workforce issues, including strengthening primary care, national workforce policy development, increasing the supply of healthcare workers, education and training of the workforce, and other supports and improvements to the existing workforce. This Implementation Brief by HealthReformGPS focuses on those provisions of the ACA that specifically target the strengthening of the nursing workforce.

Senators Bennet and Udall Give Their Support For Rural Health Programs

Senators Michael Bennet and Mark Udall signed onto a letter to the leaders of the U.S. Senate Labor, Health and Human Services, and Education subcommittee to acknowledge current fiscal constraints and request continued support for critical rural healthcare programs in Fiscal Year 2012. The programs referenced in this letter, including the National Health Service Corps, Area Health Education Centers, Medicare Rural Hospital Flexibility Program, and the State Offices of Rural Health, play significant roles in promoting access to quality care for Colorado’s rural communities. CRHC thanks Senator Bennet and Senator Udall for their leadership and support for rural healthcare. 

Process for Legislators with Appointment Authority for the Colorado Health Benefit Exchange Board To Nominate Applicants

Applicants for a gubernatorial appointment to the Colorado Health Benefit Exchange Board (established by SB 200) were required to turn in their applications to the Office of Boards and Commissions by May 23^rd.  However, some of the legislators with appointment authority are asking for the applicants to apply to them directly. Click here for the application for appointment by Representative Sal Pace (House Minority Leader). Applications for appointment by Rep. Pace must be submitted by June 20^th, and he is only considering applicants who apply to him directly.  Senate President Shaffer prefers a separate cover letter and resume as well (though not an application). Senate Minority Leader Mike Kopp is only accepting applications (to include cover letter, resume, and references) from individuals who have not applied to Governor Hickenlooper. 

Applicants should be sure to outline which of the SB 200 qualifications they bring to the Board.  The legislators with appointment authority are below—the email addresses to submit applications are available by clicking on the links. 

Senate President Brandon Shaffer

Senate Minority Leader Mike Kopp

Speaker of the House Frank McNulty--send letter and resume to this email address.

House Minority Leader Sal Pace--send application to this email address.

Please contact Alicia Haywood if you have any questions. 

White House Creates Rural Council

President Obama signed an executive order creating the first White House Rural Council. On a media call this morning, Secretary of Agriculture Tom Vilsack called the Council an “unprecedented commitment to rural America”. The Council will coordinate programs across government to encourage public-private partnerships to promote further economic prosperity and quality of life in rural communities nationwide. Healthcare is identified as one of the key factors for promoting growth that the Council will be discussing. Read more. 

Webinar on American Community Survey

The Rural Assistance Center is sponsoring a webinar on Tuesday, June 21 at 1:00pm on the American Community Survey (ACS), a continuous collection survey that provides more frequent and up-to-date data for all communities. The webinar will discuss the ACS, considerations in using it, and how rural communities can use ACS data to drive policy development. Click here for more information and to register.

California’s Efforts to Advance Telehealth

A new article discusses California’s ongoing efforts to promote and expand access to primary and specialty care in its rural and underserved communities through telehealth. The article suggests that to reduce health disparities and further expand telehealth's reach will require overcoming several financial, policy, and technical hurdles, providing insights for other states including Colorado. Read more. 

Bighorn Leadership Program Seeking Applicants from Western Slope

Interested in directly impacting the health of communities on the Western Slope? Want to influence public policy? Looking to hone your civic leadership skills? Consider applying to the 2011 Bighorn Leadership Development Program. The Bighorn Leadership Program presented by Engaged Public and in collaboration with Colorado State University are seeking individuals to participate in The Bighorn Health Care Policy and Project Lab. The Lab will include public leadership curriculum with an additional component allowing participants the opportunity to focus on the actual implementation of a health related policy or project. Individuals who live on the Western Slope and who have a specific interest in developing their own public leadership skills, health care policy and healthy living in order to better serve their communities and constituencies are encouraged to apply. The application deadline is June 24. Download the application or call 303.282.9250 ext 6 or 303.416.1531.

CMS Hosting Call on The Pioneer ACO Model, June 7 10:00-11:30am MT

The Centers for Medicare & Medicaid Services (CMS) will host a Special Open Door Forum on the request for applications for the Pioneer Accountable Care Organization (ACO) Model released on May 17, 2011. The call is on Tuesday, June 7, 10:00-11:30am MT. Dial 1-866-501-5502 Conference ID  70961782. Click here to read a full call announcement and to access background materials on The Pioneer ACO Model. 

NHQR State Snapshot

State Snapshots of state-specific healthcare quality information are now available. The state-level information used to create the Snapshots is based on data collected for the National Healthcare Quality Report (NHQR). Colorado’s Snapshot as well as other resources regarding healthcare quality and disparities are available online. 

Colorado Receives “B” on Children’s Oral Health

A new report released today by the Pew Center on the States gives Colorado a “B” for the second year in a row on its efforts to provide basic oral healthcare for children. Colorado met 5 of the study’s 8 benchmarks aimed at addressing children’s oral health needs. Read the report and download Colorado’s fact sheet here. 

Providing HIV/AIDS Prevention and Treatment in Rural Colorado

According to CDC reports, while AIDS diagnoses have slowly decreased in metropolitan areas since 1985, moderate increases in nonmetropolitan areas are emerging, reflecting the spread of the epidemic from urban into smaller suburban and non-urban areas. An article in The Rural Monitor (published by the Rural Assistance Center) highlights the work of the Northern Colorado AIDS Project in providing HIV/AIDS prevention and treatment in rural areas and some of the challenges these communities face. Read the article. 

Upcoming Call for Community Transformation Grants

The Centers for Disease Control and Prevention (CDC) recently announced the availability of $100 million to support Community Transformation Grants. In addition to smoke-free living, active living and healthy eating, these new grants will focus on high-impact, quality clinical and other preventive services, social and emotional wellness, and healthy and safe physical environments. The funding is available to support evidence- and practice-based community and clinical prevention and wellness strategies that will lead to specific, measurable health outcomes to reduce chronic disease rates.

CDC will be holding a conference call prior to the deadline for submitting Letters of Intent to apply for funding. The call for the Mountain time zone is May 25, 2011 1:00 p.m. - 2:00 p.m. (EDT). This conference call can be accessed by calling 1-888-972-9343. The leader for this call is Lori Elmore and the passcode is 8899773. The Letters of Intent are due to CDC on Monday, June 6, 2011. Click here for more information.

New Study Looks at Model for Healthcare Education and Care Delivery for Chronic Disease in Rural Communities

A new study released by Health Affairs highlights Project ECHO, an unique partnership in New Mexico between an urban academic medical center and primary care providers in rural communities. According to the authors, Project ECHO “presents an atypical example of a health care innovation in which the rural sector leads the way” and “affords an alternative model for meeting the needs of rural patients with complex diseases.” Please note this article will be available online and free-of-charge for only two weeks beginning May 19 and will then require a subscription or payment to view. Click here to download the paper.

2011 Legislative Session Wrap-Up

We posted an overview of the 2011 legislative session, highlighting several rural health bills and the FY 11-12 budget. Also check out our final bill list.

CMS Announces New ACO Options and Initiatives

The Centers for Medicare & Medicaid Services (CMS) today announced new options and initiatives for providers interested in becoming Accountable Care Organizations (ACOs).  First, the Center for Medicare and Medicaid Innovation (Innovation Center) will support a new ACO model that will be available to providers this summer – the Pioneer ACO Model, which is designed for advanced organizations ready to participate in shared savings. Second, the Innovation Center is seeking comment on the idea of an Advance Payment ACO Model that would provide additional up-front funding to providers to support the formation of new ACOs.  And third, provider groups interested in learning more about how to coordinate patient care through ACOs can attend free new Accelerated Development Learning Sessions.  Read more. 

Technology Helping Rural Communities Address Healthcare Needs

Today’s Denver Post highlights technology being used in clinics and colleges in several rural communities throughout Colorado to connect with healthcare specialists and educators. Read the article. 

Final Bill Tracker Posted

CRHC’s bill tracker is updated through the final day of the legislative session (May 11). We will update and post a complete listing of all the bills that CRHC was tracking this session later in the week.  

Informing Rural Primary Care Workforce Policy: What Does the Evidence Tell Us?

A new report by the Rural Health Research Gateway reviews 51 publications constituting the body of evidence-based research produced by the federally-funded Rural Health Research Centers from 2000 to 2010 which are relevant to the rural primary care workforce. The report looks at research in the following categories: Supply & Demand; Recruitment & Retention; Training Pipeline & Education; Lifestyle & Compensation; Nurse Practitioners, Physician Assistants, & International Medical Graduates; and New Directions for Primary Care. Download the report.

Colorado Health Benefit Exchange Board Accepting Applications

Applications are now being accepted for appointments to the Colorado Health Benefit Exchange Board and are due May 23. With the passage of SB11-200, Colorado now begins work on establishing a health insurance exchange for individuals and small businesses. The Governor’s press release provides additional information about the expertise required to be an eligible applicant. If you are interested in serving on the Board, please contact Alicia Haywood or 720.248.2748.

Upcoming Health Policy Webinars

The Colorado Health Institute is holding a series of webinars that will begin on May 25 about important health policy issues including publicly funded insurance programs, the private health insurance market, community health profiles, and the state health insurance exchange. Click here to learn more and to register.

State Budget Update

Governor Hickenlooper signed the state budget Long Bill late last week however several budget balancing bills, including bills concerning healthcare services, still require action by the General Assembly. Read more on the state budget in today's Denver Post.

Profiles of Colorado APN & PA Workforce

The Colorado Health Institute has prepared and released profiles of Colorado's advanced practice nurses and physician assistants. Download the reports and learn more about these two professions that play vital roles in our state's rural healthcare workforce.

SB 200 Passes House

SB 200, Colorado Health Benefit Exchange, passed the Colorado House today on a 44-21 vote. Thank you to all who called their representatives. We will keep you updated as SB 200 moves through its final stages of reconciling amendments and going to Governor Hickenlooper for signature. 

CMS Conference Call on May 9 to Discuss ACOs

The Centers for Medicare & Medicaid Services (CMS) is hosting a conference call on May 9^th, 2011, from 1:00-2:00 pm MDT to discuss proposed new rules for Accountable Care Organizations (ACOs). This call is intended to help the public understand what CMS, the agency administering the ACO program through Medicare, is proposing to do and to ensure that the public understands how to participate in the formal comment process. The call number is 888-989-4351, conference ID 5320738. Click here for more information on ACOs. 

Call to Action: Contact your State Representative Today

This week, the Colorado House will vote on SB 11-200, a bipartisan bill to establish a Colorado Health Benefit Exchange. A health insurance exchange will help Coloradans across the state who are seeking individual or small group insurance coverage by providing information about health insurance options. SB 200 puts Colorado on a path to develop its own insurance marketplace that will meet the unique needs of all Coloradans.

CRHC supports SB 200 and encourages you to call or email your representative today and ask them to support SB 200. Click here for contact information on all Colorado’s General Assembly members. Click here to identify your elected officials. Thanks!  

Family Physicians Impact Readmission Rates

A new report published in American Family Physician compared the proportion of family physicians and readmission rates in counties across the country. The findings indicate that hospital readmissions and costs for pneumonia, heart attack, and heart failure decrease as the number of family physicians increases. Read more. 

New Study Explores Roles of Nurse Practitioners and Physician Assistants in Improving Access to Primary Care

A new report by the Kaiser Commission on Medicaid and the Uninsured looks at the potential of nurse practitioners and physician assistants to increase the supply of primary care, in areas experiencing physician shortages as well as system-wide, as Medicaid expands to cover more uninsured adults. Read the report. 

Updated Bill Tracker

CRHC's Bill Tracker is current through April 28.

State Budget Update

As reported earlier, the FY11-12 Long Bill and several related bills went to conference committee last week. During its negotiations, the committee increased funding for the Primary Care Fund (SB 219), including $1 million for the Health Care Services Fund clinics (eligible for a $1 million federal match) and $413,500 for the Special Distribution Fund clinics. These increases bring the total state funding for the Special Distribution Fund to $2,163,500 and the Health Care Services Fund to $11,750,000 (eligible for a $11.75M federal match). The conference committee report must still be approved by the House and Senate and signed by the Governor and we will keep you updated as the budget bills advance. Thanks to the many clinics and primary care advocates who contacted their state legislators about the importance of primary care funding. 

Friday, April 29 Named Colorado Rural Health Day

In an effort to acknowledge the vital services of rural healthcare practitioners across Colorado, State Representative Tom Massey (R-60) has introduced House Joint Resolution 11-1018 to recognize “Rural Health Day” as Friday, April 29^th, 2011. Senator Betty Boyd (D-21) is the Senate sponsor. CRHC worked closely with Rep. Massey and other state legislators who co-sponsored HJR 1018 to propose a resolution recognizing the hard work being done to provide healthcare to rural communities. Read the press release and contact Sara Schmitt for more information. 

Collaboration with FQHCs

The Affordable Care Act provides a requirement that Community Health Centers (FQHCs) demonstrate that they have made, and will continue to make, reasonable efforts to maintain collaborative relationships with other health care providers in their catchment areas. Specifically, the legislation lists Rural Health Clinics, low-volume hospitals, Critical Access Hospitals, Sole Community Hospitals, and Medicare Dependent Hospitals as the entities with which a Community Health Center should demonstrate a collaborative relationship.

New Access Point grant applications and Service Expansion grants for FQHCs will be judged and scored, in part, on the extent to which they demonstrate the collaboration and coordination of the delivery of healthcare services with other healthcare providers in their service area. A November 2010 Policy Assistance Letter from the Bureau of Primary Health Care provides additional information on this expectation.

This report from Stroudwater Associates is intended to provide non-FQHC healthcare providers with a better understanding of the circumstances regarding FQHC service expansions and it also describes the collaboration efforts encouraged by HRSA when considering expansion.

Comparison Of Medicaid Provisions In Deficit-Reduction Proposals

A new issue brief from the Kaiser Commission on Medicaid and the Uninsured compares several proposals, including ones by President Obama and the House Budget Committee Chairman Paul Ryan (R-Wis.), to address Medicaid spending as part of a broad-based debt- and deficit-reduction package. Click to read the brief. 

Health Care Workforce: Future Supply vs. Demand

A new issue brief from the Alliance for Health Reform assesses the healthcare workforce, which workers are most needed, and gives strategies on dealing with the problem of shortages. Click to read the brief.

New ACO Resources

Health Reform GPS, a joint project between Robert Wood Johnson Foundation and George Washington University, has posted an overview for the Medicare Shared Savings Program for Accountable Care Organizations (ACOs).

The Broadband Speed Divide

A new article on Daily Yonder looks at broadband Internet access between rural and urban areas based on data released this year by the National Telecommunications and Information Administration. The analysis found that nationally the gap in access to broadband Internet between rural and urban areas is narrowing, however significant differences remain in choice of provider and download speeds. These issues are significant for healthcare delivery in rural areas in providing telemedicine as well as health information technology.   

U.S. Supreme Court Does Not Act on ACA

The U.S. Supreme Court deferred taking action on a bid by Virginia’s attorney general for fast-track consideration of the state’s challenge to the Affordable Care Act (ACA). The Court will have another opportunity this month to decide whether to take up the ACA for early consideration. While the Supreme Court is ultimately expected to decide the constitutionality of the ACA, several appeals courts will be hearing challenges to the law throughout 2011. Federal trial judges across the nation have upheld the law but others have declared it unconstitutional. Read more. 

1099 Provision in Health Reform Repealed

President Obama signed a bill repealing a tax-compliance mandate, known as the 1099 Provision, in the Affordable Care Act. The repealed provision, under which companies would have had to report more transactions to the Internal Revenue Service, was to have taken effect in 2012. Read more.

FY 11-12 State Budget Update

The Colorado Senate and House passed the FY 11-12 budget Long Bill and several related bills this week. Although still contingent upon the state declaring a fiscal emergency, funding for Primary Care Fund was included with $1.72 million for the Special Distribution Fund and $10.75 million (eligible for a federal match) for the Health Care Services Fund. These amounts are reductions over last year’s levels. A Senate amendment that would have added an additional $1.8 million to the Health Care Services Fund was not picked up in the House. The final package also adds monthly premiums to the Child Health Plan Plus (CHP+) program for children over 205% of the federal poverty level, cuts Medicaid provider rates by 0.75%, and reduces Medicaid funding for family medicine residency programs.

As each chambers passed different versions (including the Primary Care Fund amendment), the Long Bill now moves to conference committee, consisting of members of the Joint Budget Committee, to work out the differences. Once the committee completes its work, the budget returns to both houses for final passage. Read more.

Federal Budget Update

In Washington, Congress will be voting today on a budget compromise reached last weekend on the FY 11 budget. This agreement cuts $38.5 billion and includes an across-the-board 0.2% reduction in all non-defense discretionary accounts. Specific cuts include $600 million from community health centers and $35 million to eliminate the rural Delta Health Initiative.

While wrapping up FY 11, attention is shifting to work on the FY 12 budget and considering long-term deficit reduction plans. The House is debating a GOP budget resolution that would reduce domestic discretionary spending to below 2008 levels for 5 years, convert Medicaid into a block grant to the states, and shift Medicare into a voucher-like program in which future retirees purchase private insurance plans. In addition to his original FY 12 budget proposal, the President responded yesterday with recommendations, including streamlining Medicaid payments to states in a single rate for both Medicaid and Children’s Health Insurance Plans, strengthening a payment advisory board that would recommend cuts to reimbursement rates if Medicare costs grow too fast, and placing dual-eligible Medicare/Medicaid beneficiaries in Medicaid managed care and extending Medicaid drug rebates to this population.

The House will be debating the GOP budget resolution this week and, while it may not represent the final budget decision, this proposal does create a blueprint that could have significant negative impacts on rural healthcare providers and access to healthcare for rural communities. Please call Congress this week at 202.224.3121 and ask to be transferred to your Representative’s office to leave this message: “Please vote against Rep. Ryan’s budget resolution which will hurt critical healthcare programs for rural communities including Medicaid and Medicare.” Click here to find out who represents you. We will continue to monitor the federal budget situation and post updates. Also stay tuned for a state budget report.

2011 Report from National Advisory Committee on Rural Health & Human Services

The National Advisory Committee on Rural Health & Human Services is a 21-member citizens' panel of nationally recognized rural health experts that provides recommendations on rural issues to the Secretary of the Department of Health and Human Services. The Committee's 2011 report to the Secretary examines three key topics in health and human services and their effects in rural areas: rural childhood obesity, place-based initiatives for rural early childhood development, and the rural implications of Accountable Care Organizations and payment bundling.

Bighorn Leadership Program Seeking Applicants from Roaring Fork Valley & Colorado Springs

The Bighorn Leadership Program presented by Engaged Public and in collaboration with Colorado State University are seeking individuals to participate in The Bighorn Health Care Policy and Project Lab. The program will be taking place simultaneously in two locations: The Roaring Fork Valley & Colorado Springs. The  Lab will include public leadership curriculum with an additional component allowing participants the opportunity to focus on the actual implementation of a health related policy or project. Individuals who live in the Roaring Fork Valley or Colorado Springs and who have a specific interest in developing their own public leadership skills, health care policy and healthy living in order to better serve their communities and constituencies are encouraged to apply. The application deadline is April 15. Download the application and more information.

Webinar on Accountable Care Collaboratives in Colorado

Bringing Health Home is hosting a webinar on Thursday, April 14 from 12:00-1:00 pm titled "Accountable Care Collaboratives--what is happening in Colorado?". Accountable Care Collaboratives are a framework within which other health care initiatives can potentially thrive, such as the medical home, health information technology, and payment reform.  This webinar will introduce folks to the ACC model, the pilots underway in the Colorado Medicaid program, and how it fits with national healthcare reform. Space is limited, click here to register and learn more. 

Plan to Reduce Health Disparities Announced

In a first-of-its-kind report, the U.S. Department of Health and Human Services is recommending steps that states and communities can take to reduce health disparities. Read more.

Impact of a Federal Government Shutdown

Today's Denver Post features an article that describes the local effects of a federal government shutdown and how members of Colorado's congressional delegation are responding.

FY 11-12 Budget Updates

Colorado Senate and House leaders and the Governor have agreed on a budget for FY2011-12, to be introduced this week in the Senate as the Long Bill. The delayed Long Bill and other budget balancing efforts, including action on the Primary Care Fund, were delayed due to disagreements regarding the cuts to K-12 education, the sales tax vendor fee, and the amount of money in the state’s reserves. The bipartisan agreement includes a $250 million cut to K-12 and maintains a 4% general fund reserve. Read more about the proposed budget.

U.S. House and Senate leaders are still negotiating around the nation's FY 11 budget, facing a deadline of April 8 to avoid a government shutdown. House Republicans released their FY 12 budget proposal earlier this week, calling for significant changes to Medicare and Medicaid programs. Read more about the House proposal's impact on healthcare.  

Updated Bill Tracker Available

CRHC's bill tracker is current as of April 1, 2011. Enjoy!

Colorado CRNA Opt-Out Upheld

On March 31 in a verbal ruling, the Denver District Court found that Governor Ritter's September 2010 opt-out from the Medicare requirement that a CRNA must practice under physician supervision in rural communities and Critical Access Hospitals was consistent with Colorado law. A written order is expected to be issued soon. The ruling comes in response to a lawsuit filed against Governor Ritter's opt-out decision.


CRHC thanks the Colorado Hospital Association, Colorado Nurses Association, and the Colorado Registered Nurse Anesthetists who worked diligently to see the opt-out decision upheld. CRHC has long-supported an opt-out of CRNA supervision requirements to improve access to healthcare in rural communities and will continue to keep our readers updated on any new developments.

Accountable Care Organization Rules Now Available

The U.S. Department of Health and Human Services (HHS) today released proposed new rules for Accountable Care Organizations (ACOs). According to the HHS press release, ACOs create incentives for health care providers—including doctors, hospitals, and other providers—to work together to treat an individual patient across care settings such as doctor’s offices, hospitals, and long-term care facilities. The Medicare Shared Savings Program will reward ACOs that lower health care costs while meeting performance standards on quality of care and putting patients first.  Patient and provider participation in an ACO is purely voluntary. Read the full rules and get more information. 

CRHC will be working closely with our national partners including the National Rural Health Association and the National Organization of State Offices of Rural Health regarding the implications for rural providers and communities and on public comment. We will keep you informed with information, analysis, and opportunities to weigh in as they become available.

National Quality Strategy Released

The U.S. Department of Health and Human Services (HHS) released the National Strategy for Quality Improvement in Health Care. The strategy is the first effort to create national aims and priorities to guide local, state, and national efforts to improve the quality of health care in the United States. This report describes the initial Strategy and plan for implementation. The Strategy pursues three broad aims: better care, healthy people/healthy communities, and affordable care. Read more. 

Check Out County Health Rankings

The University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation have published online a new set of reports that compare health factors and health outcomes in counties within each state. The rankings use data from vital statistics and government health surveys. Visit the website to learn more and check out information on your county. 

Colorado's Budget Negotiations

Check out an article published today in The Pueblo Chieftain about Colorado’s ongoing budget negotiations. 

Editorial on the ACA and Rural America

Today's Denver Post features an editorial titled "A health care law for rural America" by U.S. Health and Human Services Secretary Kathleen Sebelius and Agriculture Secretary Tom Vilsack about provisions of the Affordable Care Act that assist rural communities.

FY 11-12 Primary Care Fund Update

As reported in earlier posts, the Joint Budget Committee was considering significant cuts to Primary Care Funds, including eliminating the Special Distribution Fund that assisted 16 community-funded safety net clinics and rural health clinics. CRHC, ClinicNET, and many affected clinics worked diligently in recent days to educate JBC members about Colorado's diverse healthcare safety net and the need to support these clinics. Earlier this week, the JBC voted to restore funding for the Special Distribution Fund by $1.7 million and add additional monies to the Health Care Services Fund (for community health centers and other indigent care clinics) for a total of $21.5 million in federal and state funds. While these amounts still represent cuts, the funds provide some relief for these clinics. Please contact Sara for more information and we will post additional updates as the FY11-12 budget negotiations unfold.

Health Insurance Exchange Bill Introduced

On Monday, March 21, Colorado Senator Betty Boyd (D-Lakewood) and Representative Amy Stephens (R-Colorado Springs) introduced the Colorado Health Benefit Exchange Act, SB 11-200. The bill establishes the governing structure of the nonprofit public health insurance exchange, or marketplace where individuals and small businesses can shop for and purchase health insurance. The bill also creates a governing board and a legislative oversight committee. The board will consist of 9 voting members and 3 non-voting ex-officio members, with all voting members needing to have expertise in one of several specified skill sets (including healthcare delivery). Appointments shall be coordinated to provide broad geographic representation. Click here to read the bill.

CRHC is currently reviewing the bill and has not yet taken an official position. We will post additional information to the bill tracker and please contact Alicia Haywood at ah@coruralhealth.org for more information or with any questions. 

The Forum 2011: Essential Perspectives for Safety Net Providers, April 20-21

The Forum is a two-day conference that will bring together participants from across Colorado and surrounding states. Presented by CRHC and ClinicNET, The Forum is an essential educational, training, and networking event for all safety net clinics, members of the clinical team, and other interested parties. Scheduled agenda topics include federal and state policy updates, patient centered medical homes, a funders panel, and Colorado’s health insurance exchange. Opportunities for sponsorships are now available. Learn more about The Forum and register online. 

March Revenue Forecast

The Governor’s Office of State Planning and Budgeting (OSPB) and Legislative Council presented their March 2011 revenue forecasts to the Joint Budget Committee (JBC) this afternoon. The findings indicate higher than expected tax revenues and, combined with budget cuts already approved, the projected budget shortfall for FY11-12 has been revised from $1.0 billion to $450 million. Modest economic growth is expected for the near future, requiring the state to still make difficult budget cuts.  Read the OSBP and the Legislative Council reports for more information.

CRHC’s Role in NRHA’s Rural Health Congress

National healthcare issues directly impact rural providers and communities. Several CRHC staff currently serve on the National Rural Health Association’s (NRHA) Rural Health Congress and constituency groups and are committed to advocating on behalf of the interests of rural healthcare providers in Colorado and nationally to ensure NRHA policy positions are strategically designed to promote providing high quality healthcare services to rural areas.

CRHC has a long-standing, 20 year history as an organization with active membership in NRHA. CRHC founder and former Executive Director, Denise Denton, served as NRHA President in 1993. CRHC staff have held leadership roles in NRHA’s Constituency Groups (CG) which ultimately advise the Rural Health Congress in taking positions on key advocacy and policy positions for rural healthcare. Lou Ann Wilroy, CRHC CEO, has served for ten years on the Frontier Constituency Group, addressing healthcare issues in the nation’s most sparsely populated communities.  Michelle Mills, CRHC’s Program Director for Critical Access Hospitals and Rural Health Clinics, has been a member of the Rural Health Clinics Constituency Group since late 2010. Michelle is also the RHC CG representative on the Rural Health Congress. Cari Fouts, Communication & Development Director for CRHC, is a member of the State Association Council CG for NRHA and was appointed a position on the Rural Health Congress in January 2011 to represent the needs of all rural communities and state rural health associations across the nation.

Specific topics that are being addressed by the Rural Health Congress this year include:

• Health reform implementation
• Accountable Care Organizations
• Medicaid Payments
• CAH, RHC, Frontier Stay Extended Stay Clinics– discussion of potential development of new certification and payment methods (spearheaded by Tom Henton, CEO of Conejos County Hospital in Colorado; also a member of the Congress)
• Primary Care Shortages
• Rural General Surgeon Shortages
• EMTALA & Telehealth
• Mental Health in Rural America (expand to include substance abuse)
• Deleterious Impacts on Rural Multiracial & Multicultural Populations due to decrease in Welfare Programs
• Network Neutrality
• Broadband – Rural Access
• Tobacco Use in Rural America

As the Rural Health Congress moves forward in adopting positions, CRHC will seek input from our members to ensure the policy briefs meet the needs of our constituents. CRHC’s Policy & Legislative Council (PLC) guides and informs CRHC’s state and federal policy activities. If you would like more information about the PLC or are interested in participating, please contact Sara Schmitt at ss@coruralheatlh.org. If you have any questions about the Rural Health Congress, please contact Michelle Mills, mm@coruralhealth.org, or Cari Fouts, cf@coruralhealth.org. Learn more about NRHA’s Rural Health Congress.

CRHC, CCMU and ClinicNET – In Search of Health Stories to Create a Shared Statewide Vision

Got a health story to tell? The Colorado Rural Health Center, Colorado Coalition for the Medically Underserved, and ClinicNET are ready to hear it.

CRHC, CCMU, and ClinicNET will hit the road in April in search of Colorado health stories. “The purpose of Colorado HealthStory is to create an appreciation of our shared experiences of health, one conversation at a time,” said Alicia Haywood, policy analyst with the Colorado Rural Health Center. “We invite Coloradans to tell their own health stories to begin a dialogue about access to health in our communities.”

The three-year project was made possible through funding from The Colorado Trust and the Colorado Health Foundation. Over the next three years, Colorado HealthStory collaborators will engage existing and new partners to identify 250 storytellers and capture their stories. Personal health stories will be audio recorded with a family member, a friend, a care provider, a mentor or HealthStory collaborator. Each storyteller will be provided a CD of their story recording, and a second copy will be retained in the Colorado HealthStory archive.

Stories will be available on the Colorado HealthStory Web site, blog and other social media outlets, and news and media outlets will receive periodic project updates. In addition, once a body of stories is collected from each participating community, Colorado HealthStory will convene community forums known as “listening sessions.” Using information gathered from collected stories, listening sessions and local health data, the HealthStory team will create “community health profiles” for each participating community.

“Sharing your own health story is a great way to start, but there are lots of other ways you can help your family, friends and neighbors share their story,” Haywood said. “You can host a ‘HealthStory Day’ at your organization, co-author an op-ed in your local newspaper that encourages others to share their stories or link to the Colorado HealthStory site, (coloradohealthstory.org, but not yet launched) from your Web site.”
 

For more information on Colorado HealthStory, contact Alicia Haywood of the Colorado Rural Health Center at ah@coruralhealth.org or by calling 720.248.2748.

Implementation Brief: Primary Care Physician Workforce

Federal health reform legislation contains dozens of provisions related to health care workforce issues, including strengthening primary care, national workforce policy development, and increasing the supply of health care workers. A new Implementation Brief from George Washington University and Robert Wood Johnson Foundation focuses on those provisions that specifically target the strengthening of the primary care physician workforce.

2010 Colorado Health Report Card

The Colorado Health Foundation released its 2010 Colorado Health Report Card. The report card includes detailed information about 38 health indicators to provide a comprehensive picture of the health of Colorado's residents. The state's overall health grades have not improved significantly since the first report card in 2006. The only grade that improved from 2009 was "healthy aging", which moved from a B+ to an A- this year. Read more.

Updated CRHC Bill Tracker

Bill tracker is updated through March 9, 2011.

JBC Makes 2011-2012 Budget Recommendations for HCPF

Yesterday the Joint Budget Committee (JBC) conducted “figure setting” for Health Care Policy & Finance, setting budget numbers for many healthcare programs that will go into the FY 2011-2012 Long Bill, or the state’s budget. The state has an estimated $1 billion deficit for 2011-2012 and deep cuts are being made in many government services and programs. The JBC recommended several Medicaid program reductions, including a 0.75% medical provider rate cut and reduced oral health benefits, but did not recommend a provider payment delay at this time. Additional cuts included $19.2 million in Amendment 35/Primary Care Funds and reduced payments to family medicine residency programs. The JBC’s actions do not represent the final budget, as House and Senate members need to approve the Long Bill. However, further cuts may be needed if the March revenue forecast (due out later this month) is dismal. If you would like more information or have questions or concerns, please contact Sara Schmitt at ss@coruralhealth.org or 303.468.3498. 

Issue Brief: Insurance Coverage and Access to Care in Primary Care Shortage Areas

An issue brief by the Kaiser Family Foundation examines insurance coverage and access to care among the nonelderly who live in geographical primary care health professional shortage areas (HPSA). The analysis found that when compared with those who live outside geographical HPSAs, these individuals were more likely to be uninsured or be covered by government insurance and to have a chronic condition. The authors discuss the need to address healthcare workforce shortages to meet both current and future demand for services in these areas and suggest several policy options to consider. The brief is a concise summary of many issues familiar to The Rural Voice readers and rural communities. Download the report. 

Participate in Creating Colorado's Economic Development Strategy

Colorado’s “bottom up” economic development planning continues, with several meetings scheduled throughout the state in the coming days. CLICK HERE to find the meeting in your region. Please consider attending and serving as a voice for healthcare in this discussions. 

Attend the Rural Economic Development Summit in Greeley on March 14. Click here for the schedule and more information.

Please attend these events and underscore the importance of healthcare as a rural economic driver.  Consider these facts: 

• Many healthcare providers are self-employed entrepreneurs; 
• Assuming the same ratio of providers to overall population, Colorado will add 5,000 new healthcare jobs per year for the foreseeable future; 
• On average, one in eight Colorado jobs is in the healthcare sector. In rural counties, the average is closer to one in six jobs; 
• Taking into account multiplier effects, each healthcare job supports about two additional jobs. 

·         As a powerful economic engine across Colorado, healthcare must be at the table during economic development talks. For more information, contact Clint Cresawn at 720.248.2745 or 800.851.6782, ext. 255, or by email at ccr@coruralhealth.org. 

CRHC Updated Bill Tracker

Bill tracker is updated through March 3, 2011.

State Budget Primer

As Colorado works to balance its current budget and plan for the upcoming year, a resource from The Colorado Fiscal Policy Institute provides helpful information and background. The Colorado Budget Primer is a detailed explanation of how the state’s budget is formed, the major players in the process, terms for understanding the state budget, and state and federal limits on revenue and spending.

Define Rural Before You Budget for It

How many times have you been asked to define rural? Timothy Collins, assistant director of the Illinois Institute for Rural Affairs, was asked to address this issue before the U.S. House Agriculture Subcommittee on Rural Development, Biotechnology, and Foreign Agriculture last month. A quick answer for Collins, and for many of us in a pinch, typically is ‘you know rural when you see it’ but he suggests that “this approach doesn’t fly when it comes to policy implementation and the distribution of billions of dollars for rural development projects.” Read his post in Daily Yonder. 

2010 Colorado Health Insurance Report Available

The 2010 Colorado Health Insurance Report contains information about the cost of health insurance and the factors that drive the cost of health insurance premiums on an individual and group basis in the state. Released by the Division of Insurance annually, the report includes financial information on health carriers and how Colorado’s health coverage and options compare nationally. Read the report.