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Health In Colorado. 22% of adults obese; 14.2% kids 18.3% working age adults uninsured; 9.3% kids 20.7% of women receive initial prenatal care later than the first trimester or not at all 28.7% of preschool-age children do not receive all recommended doses of six key vaccines.
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Health In Colorado • 22% of adults obese; 14.2% kids • 18.3% working age adults uninsured; 9.3% kids • 20.7% of women receive initial prenatal care later than the first trimester or not at all • 28.7% of preschool-age children do not receive all recommended doses of six key vaccines. • 14.8% of adults reported having poor mental health
Key Wins for Kids Public Coverage • CHIP extended to 2019 • Investments in home visitation and school based health centers • Preventive services for children with no cost sharing • Screenings, immunizations, physical, oral, hearing, dev assessments • Youth in foster care will be Medicaid eligible to age 26 • Medicaid eligibility for parents • Studies have shown that gains in coverage for parents result in gains in coverage for children and that the health of the parent is a major determinant in the physical and mental health of the family Private Coverage No pre-existing condition exclusions or pricing based on health status Young adults can stay on their parents health insurance to age 26 No lifetime or annual limits Coverage of preventive health services at no cost Coverage expansion for parents through subsidies in the exchange
Coverage Coverage • Medicaid expansions up to 133% of poverty • Premium tax credits available up to 400% of poverty • Cost sharing subsidies up to 250% of poverty (limits out of pocket spending) • Investments in workforce and clinic capacity
Medicaid Expansion: The Right Choice for Colorado (SB13-200) • Expansion allows Medicaid to cover more than 160,000 additional Coloradans • Expansion allows us to cover more people with the right services at the right time and drive value in the system • 58,000 additional parents and adults likely to enroll between 100%-133% of FPL (138% with an automatic 5% income disregard) • In 2013, 133 percent of the FPL was $31,321 for a family of four and $15,282 for an individual • Supports Colorado’s health and economy by helping people stay healthier over the long term • Maximizing enhanced federal funding is the best option for Colorado • Allows provider fee dollars to stretch further with the enhanced federal matching funds • The Medicaid expansion is expected to have no impact on the state General Fund
What is the Colorado Health Benefit Exchange? An open, competitive marketplace soon to be called Connect for Health Colorado for individuals and small employers to: Compareinformation regarding cost and quality Shophealth plan features containing the same base benefits Determineeligibility for and access new federal financial assistance, based on income Support thehealth coverage decision-making process Call, text or sit down with trained representative for help Enrollin a health plan
Coverage Options by Income Coverage Options by Income Citation: The Center for Public Policy Priorities ( www.cppp.org ) Family Income
Health Insurance Status after Implementation Uninsured Without HR implementation Uninsured after HR implementation 758,000 Insured after HR implementation 220,000 160,000 160,000
Insurance reforms Insurance Accountability
Bending the cost curve Cost Containment Coordinated Care Models in Colorado • Patient-Centered Medical Homes • Accountable Care Collaboratives • Reforming payment systems (HB1281) • Leveraging health information technology Preventing and Managing Chronic Disease
Accountable Care CollaborativeUpdate • The Department reduced Medicaid health costs by $20 million • Returned nearly $3 million to state and federal taxpayers since its inception Indicators- ACC Clients • Hospital Readmissions 8.6% reduction • Emergency Room Utilization .23% increase • High-Cost Imaging 3.3% reduction
Questions Lorez MeinholdDeputy Executive Director/ Director of Community Partnership Office 1570 Grant Street Denver, CO 80203 (303) 866-5868lorez.meinhold@state.co.us