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Health Trends Impacting the Colorado Landscape

Health Trends Impacting the Colorado Landscape. Today’s Topics. A brief introduction to CHI The Colorado Context: 6 Trends Upcoming Legislative Session. A Brief Introduction. CHI is a trusted and leading source of credible health information for Colorado leaders. Our insight is used to:

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Health Trends Impacting the Colorado Landscape

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  1. Health Trends Impacting the Colorado Landscape

  2. Today’s Topics • A brief introduction to CHI • The Colorado Context: 6 Trends • Upcoming Legislative Session

  3. A Brief Introduction • 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

  4. Our Focus: Stakeholder Communities

  5. The Colorado Context

  6. Colorado Trends • But will it play in Pueblo? Affordability and individual responsibility. • I want my PCP! Who will we provide additional care? • Medical homes: Heroes or hassles? • Colorado constraints: Current market and politics • Building Out and Wiring Up: Our big investments to reshape health • HEAL Thyself!

  7. ACA: Incenting New Behaviors

  8. #1: But will affordability play in Pueblo? Source: CHI analysis of 2008-09 COHS

  9. Affordability: What CHI is Watching • New regulations • Market behavior One in three Coloradans are uninsured or underinsured. Coloradans by insurance status, 2008-09 Adequately insured Under- insured Insured, with uninsured family member Uninsured Source: The Colorado Trust (2010). The magnitude of underinsurance in Colorado.

  10. Who will still be uninsured in CO? Uninsured after HR implementation Uninsured Before HR implementation 800,000 258,000 214,000 153,000 175,000

  11. Individual Responsibility and Employer Implications • What about the role of patients? • Individual mandate • Value based design and purchasing • Readmissions and patient safety

  12. #2: I want my PCP! Colorado’s workforce faces two major challenges: (Mal)distribution of providers Providers choosing specialty care over primary care Tomorrow, we will face a distribution problem AND a shortage problem. Today, we face a distribution problem.

  13. Our primary care workforce • Percent of CO providers working in primary care • 39% of Physicians • 43% of Physician Assistants (PAs) • 65% of Advanced Practice Nurses (APNs) • < 20% of medical students choose primary care

  14. Scope of Practice Training costs and societal investment Market dynamics push to lowest cost provider

  15. #3: Medical Homes: Heroes or Hassles? • Reduce costs • Improved care quality • Reduced medical errors • Higher patient satisfaction • Fewer health disparities

  16. The Promise Deferred • It won’t be today or tomorrow • Medical homes require transformation • Workforce as members of “care teams” • Technology is not “plug and play” • Health care neighborhoods • Payment reform

  17. What CHI is watching • The Colorado Multi-Payer, Multi-State Patient-centered Medical Home Pilot • ACCs and Medicaid • Political appetite to invest?

  18. #4: Colorado Constraints • Our market today • New administration • Divided houses • Fiscal crisis • The shadow of ACA

  19. #4: The Colorado Flavor of Reform

  20. Doing more with less (and less) $100 million budget reductions for FY 2011-12, including… $10.3 million Early detection and treatment funds $2.5 million Medicaid children’s oral health services $1.6 million Women’s Wellness Connection program $17.7 million Tobacco education programs $3 million Health disparities grants $11.7 million Medicaid Provider Fee reduction $2.7 million Safety net clinics

  21. #5: Building Out and Wiring Up • Physical infrastructure • The ACA allocates $11 billion to FQHCs • 3 Major Initiatives in Colorado • COHRIO, QHN and EMR • APCD • State Insurance Exchange

  22. The Colorado Health Insurance Exchange A health insurance exchange is an organized marketplace for customers to shop for health insurance based on price and quality. #COHIEX

  23. #6: HEAL Thyself!

  24. Implications for Employers • Grants for small employers • Efforts to maximize employee engagement • Initiatives to change unhealthy behaviors and lifestyle choices • Supportive environment efforts • www.hhs.gov

  25. Colorado Legislative Session: 2011 and 2012

  26. What to Expect 2012 • Health reform alignment • Individual responsibility arguments • Workforce supply issues • Cost savings • Public insurance and structural deficits • Private insurance: cost to employers

  27. Contact Information Michele Lueck President and CEO Colorado Health Institute lueckm@coloradohealthinstitute.org 720.382.7073 Colorado Northwest Community College Nursing Graduates, 1965

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