Building Blocks to Health Care Reform

1. Office of Governor Bill Ritter, Jr. Building Blocks to Health Care Reform Cody Belzley March 20, 2008

2. Overview • Health Care in Colorado: Snapshot • Governor Ritter & The Colorado Promise • Progress & Accomplishments • 208 Commission & Vision / Values • Building Blocks to Health Care Reform • Next Steps

3. Colorado Health Care Snapshot • Spending $30B per year and growing; Despite that… • Nearly 800,000 uninsured • Relatively Healthy State, BUT… • Some of the Best Care, BUT… • Colorado Concerns: • Small Business is Backbone of Economy • Rural & Urban Challenges • Existing Public Programs are Lean

4. Colorado Health Care Snapshot Source of InsuranceNumbers in Thousands – Source: June 2007 Lewin Report

5. Colorado Health Care Snapshot Characteristics of the Uninsured • 70% of the uninsured are in the workforce or are the dependent of a worker • 32% of the uninsured have family incomes of $20,000 or less; 13% have family incomes of $75,000 or more. • 40% of the uninsured are between the ages of 19 and 34; Almost 20% are children • 57% of the uninsured are white • About $1.25 billion will be spent on Colorado’s uninsured in 2007 – 2008. The uninsured pay for about ½ of their care out of pocket. TEXT TEXT TEXT TEXT Source: 208 Commission Report – January 2008

6. The Colorado Promise • Basic health care should be available and accessible to all Coloradans. • High quality health care should be available and accessible regardless of geography. • Health care for the 180,000 uninsured children should be an immediate priority. • Health care should be affordable and financed in a cost-effective manner. • Medicaid must become more efficient and effective. • We should foster competition as a means to drive quality up and costs down. • We all must take personal responsibility for our own health. • Health care reform must be developed collaboratively.

7. Progress & Accomplishments • Launched a Preferred Drug List for Medicaid • Enrolled 10,000 additional kids in CHP+ & Started Medical Home pilot program • Expanded mental health benefits in the small group private market • Released the first-ever CO. Hospital Report Card • Invested in immunizations • Launched anti-obesity & rural health initiatives with private sector partners • Piloted important disease management programs

8. Health Reform Research 208Commission • 2006 Bi-partisan Commission created • 27 very diverse members • 15 months, 31 proposals, 24 community meetings • Delivered recommendations to Legislature Jan. 31 • Historic, important Vision / Values • Complimentary to 208 • 11 meetings in 9 cities with community leaders from public, private and non-profit sectors • Nov & Dec 2007 • Focused on the vision for a stronger health care system and the values guiding that vision • Final report released February 13

9. Building Blocks Plan • Bold and Realistic Reform • Improves Quality, Addresses Cost and Expands Access • $25M General Fund -- $63M Total Investment (State & Federal Funds) • Follows closely the recommendations of 208 Commission and reflects Vision / Values we heard from community leaders

10. Building Blocks Plan Kids Expansions & Public Program Improvements • CHP+ eligibility to 225% FPL this year – permissive up to 250% FPL (SB 160 + Budget Package) • Taken with 2007 enrollment gains we’ll cover an additional 55,000 kids over 3 years • Provide a Medical Home to all Medicaid & CHP+ kids (Budget Package) • Centralize eligibility determinations (Budget Package) • Increase Medicaid reimbursement for primary & oral care (Budget Package) • Improve mental health benefits in CHP+ (SB 160 + Budget Package)

11. Building Blocks Plan Center for Improving Value in Health Care • Inter-disciplinary, multi-stakeholder center • Identify & pursue strategies to improve quality & contain costs • Long-term approaches to re-align our health care system • Joan Henneberry leading

12. Building Blocks Plan Improve Efficiencies & Increase Transparency • Standardize health plan ID cards (SB 135) • Create a web-based Health Plan Report Card (Late Bill) • Require insurance brokers to disclose their compensation (Late Bill) • Invest in Health Information Technology through support of CORHIO (Budget Package) • Study strategies to improve access to quality care, particularly in rural & underserved communities (Scopes of Care Study) • More aggressively manage chronic diseases for Medicaid patients (Underway)

13. Building Blocks Plan Important first step & working together with you, we’ll continue to make progress: "My vision remains the same – that high-quality, affordable health care is available to every Coloradan. We can help make this vision a reality by working together, by working with broad coalitions that include public and private partners, and by working with bipartisan leadership that puts our future first." -Governor Ritter, Feb 13, 2008-

14. Next Steps • Help us ensure that these Building Blocks are put in place – support the Budget Request, SB 160 & SB135 and late bill on health plan transparency • Support the efforts of the Center for Improving Value & the Scopes of Care Study • Continue to engage with us to develop the next set of building blocks