Colorado Department of

1. Colorado Department of Health Care Policy & Financing

3. 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

4. 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

5. 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 

6. Cost of Expansion *This is a preliminary estimate of caseload and expenditures and does not include administrative costs or effects of other programs. **The total estimates column above takes into account calculations for eligible but not enrolled individuals and changes to the CHP+ costs and caseload. 1 An estimated more than160,000 Coloradans will be enrolled as a result of the expansion. This is difference between 271,000 (above) and an estimated 110,200 parents and adults without dependent children currently authorized under the provider fee. 2 As federal funding tapers, we anticipate savings, provider fees and other public funding will cover the additional caseload.

7. 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

8. Insurance reforms Insurance Accountability

9. 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

10. Improving Value in Medicaid: $280 million in savings over 10 years • Enhancing value-based services • Increasing effectiveness in care delivery • Reforming payment systems to reward value instead of volume • Leveraging health information technology to improve quality and efficiency of care • Redesigning administrative infrastructure and reducing fraud, waste and abuse

11. 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

12. Payment Reform Courtesy: Colorado Health Institute 10

13. Coverage Options by Income Coverage Options by Income Citation: The Center for Public Policy Priorities ( www.cppp.org ) Family Income

14. Questions Lorez MeinholdDeputy Executive Director/ Director of Community Partnership Office 1570 Grant Street Denver, CO  80203 (303) 866-5868lorez.meinhold@state.co.us