CHI is hosting a series of webinars designed especially for Colorado health care leaders who need credible, timely information to help them make informed decisions. This webinar provided an overview of publicly-funded insurance programs in Colorado, such as Medicaid and the Child Health Plan Plus (CHP+).

1. The Changing LandscapeIn Colorado for Publicly-funded Health Insurance Programs 1 May 25, 2011 Colorado Health Care Leaders Webinar Series

2. A Brief Introduction to CHI CHI is a trusted and leading source of credible health information for Colorado leaders. Our insight is used to: Inform policy Contribute to effective implementation Support state efforts to improve health 2

5. Medicaid Health insurance program for low income parents, children, elders and people with disabilities Financed by federal and state government, but administered by the states Provides acute and long-term care services (580,000 enrollees in Colorado) States that participate must cover mandatory populations and services 5

6. Child Health Plan Plus (CHP+) Created in 1997 and jointly financed by states and the federal government Serves low income children and pregnant women who do not qualify for Medicaid (up to 250% of FPL) Families pay annual enrollment fee Currently 68,000 children and1,900 pregnant women enrolled 6

7. Colorado Indigent Care Program CICP is not insurance coverage Clinics and hospitals partially compensated for care provided to uninsured and underinsured individuals (at or below 250% of the federal poverty level) 218,000 individuals served through CICP in FY 2009-10 7

8. Current eligibility standards for programs in Colorado 8

9. Medicaid caseloads have been increasing SOURCE: Colorado Department of Health Care Policy and Financing, Executive Budget Request, Nov. 1, 2010 9

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12. Distribution of Medicaid enrollment and expenditures by eligibility category SOURCE: Colorado Department of Health Care Policy and Financing, Executive Budget Request, Nov. 1, 2010 12

13. Appropriations are increasing for HCPF SOURCE: Colorado Department of Health Care Policy and Financing NOTE: Includes all appropriations to the Department of Health Care Policy and Financing. FY 2010-11 includes original appropriation, FY 2011-012 includes Nov. 1, 2010 request. 13

14. Colorado Health Care Affordability Act (H.B. 09-1293) Eligibility expansion funded without General Fund expenditures State assesses hospital fees and draws down federal Medicaid match State using additional federal funds to expand eligibility for Medicaid and the Child Health Plan Plus (CHP+) In return, hospitals receive increase in Medicaid and CICP payments 14

15. Recent initiatives Increased outreach and enrollment Medicaid Value-Based Care Coordination Initiative Utilization controls and benefits reviews Increased payment recoveries and emphasis on fraud reduction Denying claims for hospital re-admissions within 48 hours 15

16. Medical homes Team approach Comprehensive, continuous, coordinated care Preventive care, health education, coordination of care and medications Between 2009 and 2010, percentage of children without a physician visit declined from 32% to 6% 16

17. Accountable Care Collaborative Integrates patient-centered medical home model with analysis of data Outcome-based model of care 7 Regional Care Collaborative Organizations Care coordination, medical and network management Shared accountability with providers for outcomes and costs 17

18. Federal policy changes to publicly funded health insurance programs 18

19. Current eligibility standards for programs in Colorado 19

20. Eligibility standards in Colorado after state and federal health reforms NOTES: Federal health reform does not make changes to Medicaid eligibility for elders and people with disabilities. CICP will likely continue to serve individuals who do not qualify for Medicaid or CHP+ or are uninsured or underinsured. 20

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22. Other federal initiatives addressing cost and quality Center for Medicare and Medicaid Innovation Medical and health homes Accountable care organizations Bundled and global payments Federal Coordinated Health Care Office 22

23. Future webinars June 8 – The Private Market June 22 – A Profile of Your Community’s Health July 20 – The Colorado Health Insurance Exchange Register for all webinars at: www.coloradohealthinstitute.org/webinars 23

24. Questions? Amy Downs Director for Policy and Research Colorado Health Institute (720) 382-7091 downsa@coloradohealthinstitute.org 24