Preparing for AwDC Expansion

The AwDC expansion is intended to start (on a limited basis) on April 1st of this year. Since the approach is different from how other program changes have occurred in the past, it is critical that you get educated on the details and share with your networks.

Here's a list of helpful documents and webinars:

• Updated documents from the Department of Health Care Policy and Financing including FAQs and fact sheets.
• Statewide meetings and webinars hosted by HCPF for eligibility workers and general community members are continuing. Register for a meeting near you! 
• Colorado PEAK, the state web-based application for medical and non-medical programs, has trainings and webinars. Information available here and dates here. 
• Updated Connect Campaign Resource List for assisting clients with needs besides Medicaid coverage.

An Appeal for Your Support

ClinicNET’s mission is to strengthen Colorado’s health care safety net by empowering organizations that serve vulnerable populations. We actively work to enhance the capacity of Community-Funded Safety Net Clinics (CSNCs) and federally certified Rural Health Clinics (RHCs) to serve medically vulnerable Colorado residents. Currently, there are 36 CSNCs and 52 RHCs, which includes clinics in urban, rural and frontier communities who provide healthcare to people who are low-income, uninsured and underinsured.

The work and mission of our affiliate clinics and the strength of our partnerships have given ClinicNET a trusted voice with government officials, policy professionals, and funders during this critical time of health care reform. Especially important is our partnership with the Colorado Rural Health Center enabling technical assistance opportunities for affiliate clinics.

Although technically not a membership or fee-for-service organization, ClinicNET does encourage financial contributions from the affiliate clinics it serves. Additional funding helps us continue to:

• Advocate for and increase the recognition of affiliate clinics as key safety net providers
• Support clinic participation in strategic patient care initiatives such as patient-centered medical home and quality improvement initiatives
• Provide education, resources, support and technical assistance
• Improve the HIT/HIE capacity of clinics
• Facilitate improved clinic data collection

We hope you will consider making a meaningful contribution in support of our valuable efforts.

Filling the holes in Colorado's safety net

This is an excerpt from the Colorado Coalition for the Medically Underserved's blog. Click here to read the full article.

Having health insurance means fewer emergency room visits, less unbearable medical debt, more chronic disease management, and more preventive and primary care services. Many Coloradans who work hard every day to keep our state running—the gas station clerks, the seamstresses, the maintenance workers, the state employees who are not allowed (by state law) to participate in CHP+ for their kids even though their income is low enough—are left to try and find affordable coverage on their own or to utilize the state’s safety net. Our safety net is there to catch those for whom the system isn’t working—it has hundreds of providers who care deeply about our state’s most needy and thousands of programs, clinics, and community organizations doing great work to improve coverage and access; but our safety net is still a net, after all, and nets have holes.

To read the complete article, click here.

Update: Adults without Dependent Children Medicaid Expansion

Guest post by Aubrey Hill, Health Systems Analyst for the Colorado Coalition for the Medically Underserved

The planned Medicaid expansion for low-income adults without dependent children has undergone a few changes in its implementation plans. The program will initially roll out on a limited basis, will only be available for those who have incomes below 10% of the federal poverty level, and will only be available for 10,000 persons. The method of determining who will be the 10,000 is by random selection, as opposed to first come, first serve. All others who would otherwise be eligible will be put on a wait list.

Applications can be first submitted in on April 1 of this year (but if received for processing earlier, the application will be denied), and the first random selection process will be run on May 15. Each month thereafter, if there are spots that happen to open up on the Medicaid program, additional random selection processes will be run to keep the program filled.

This means that all estimated 49,511 adults without dependent children who live under 10% of the poverty level (or single adults earning less than $100 a month, or a couple earning less than $122 a month) will continue to have a chance to get on the program after its initial roll-out. For more information about this program, check out these resources from the state Medicaid agency (HCPF).

While we think it is likely that this program will happen as expected, these new decisions are still pending approval from the Centers for Medicare and Medicaid Services (CMS) at the federal level.

Also, encouraging folks to apply for this new eligibility category, the hope is that more folks will receive the opportunity to receive other resources they are eligible for such as food and/or cash assistance and CICP. Since clinics presumably are already seeing much of this population, assisting the newly eligible with their benefits and assisting the ineligible with applying for other services will be key to answering the needs of the entire population. To help folks meet their needs outside of Medicaid, check out this list of statewide resources.

New report on Integrating a Safety Net into Health Care Reform

A 2011 Commonwealth Fund poll found that 98 percent of responding national health care opinion leaders believe that traditional safety net providers will still fulfill critical roles after implementation of the ACA. With the support of The Commonwealth Fund, NASHP formed the National Workgroup on Integrating a Safety Net into Health Care Reform Implementation to inform national and state policy development in addressing the roles of safety net providers in implementation of the ACA. This brief describes 10 overarching issues that the National Workgroup identified as ones that policymakers concerned with the safety net will need to consider in order to achieve health care reform goals, particularly for vulnerable populations.

> Read the full report

New Seats on the ACC Advisory Committee

HCPF is adding two new seats to the Accountable Care Collaborative (ACC) Program Improvement Advisory Committee. One seat will represent dually eligible individuals (Medicare and Medicaid), and one seat will represent the adults without dependent children. These committee members will act as liaisons between the ACC Program Improvement Advisory Committee and the AwDC Advisory Committee and Duals Stakeholder Groups, as the Department plans to enroll both dually eligible individuals and adults without dependent children into the ACC program. Information about the committee, as well as an application, may be found here.

Applications are due March 15th. You may return your application to the Department by faxing it to (303) 866.2803, or you may attach it in an email and send it to ACC@hcpf.state.co.us. For more information, contact Kathryn Jantz at the Department.

Mental Health Initiatives Grants

Bristol-Myers Squibb Foundation: Mental Health and Well-Being

The Bristol-Myers Squibb Foundation works to reduce health disparities by strengthening community-based healthcare worker capacity, integrating medical care and community-based supportive services, and mobilizing communities. The Foundation’s Mental Health and Well-Being initiative leverages public and private sector partners in the community and outside the clinic to increase disease awareness, educate patients about effective self-management of their illness, reduce stigma, and provide emotional support. Grants are provided to nonprofit organizations that address one of the following issues: the mental health needs of returning military service members, veterans, and their families; or the over-representation of the mentally ill in the criminal justice system. Letters of inquiry must be submitted via email by April 13, 2012. Visit the Foundation’s website to review the letter of inquiry guidelines.

Reducing costs through better care collaboration

This is an excerpt from an article in the Healthcare Finance News. Click here to access the full article.

For the past several decades, the U.S. healthcare system has rewarded the provision of high-volume, specialized patient care—and, as a result, we have seen costs skyrocket and our collective health suffer.

By contrast, the patient-centered medical home (PCMH) healthcare delivery model is a collaborative, team-based approach with the primary care physician (PCP) at its nexus. With financial and clinical risk shared among providers and health plans, it has the potential to not only improve care, but also to contain costs.

If there is one thing the healthcare industry has learned, it is that chronic illness drives high costs. Chronic illness often is rooted in poor preventive health habits and is responsible for a large portion of patient encounters in the current delivery system. In fact, some 70 percent of deaths in the United States are the result of preventable conditions, generally caused by diet, lack of exercise, smoking, and obesity.

Take, for example, the many diabetic patients who suffer from multiple co-morbid conditions. Under the current highly fragmented healthcare delivery system, they often receive care from several different physicians. With no collaboration among providers, these patients are subject to gaps in care, redundant testing, and greater exposure to medical error.

By contrast, the PCMH model offers financial incentives for PCPs, specialists and healthcare plans to share their data—thereby avoiding redundancies and identifying gaps in care before they result in hospitalization and emergency room visits. A 2009 study of a PCMH pilot in Seattle showed that after one year, patient ER visits declined by 29 percent and hospitalizations dropped by 11 percent versus a non-PCMH control group.

Wellness programs aren’t new, but new accountable care models like PCMH have the power to make them more effective, with more patient stakeholders invested in their positive change. Ultimately, lower costs will come when financial and clinical incentives spur providers and payers to hold patients accountable for the kinds of behavioral changes that lead to better health.

Read the rest of this article to learn how technology can be used as a bridge and how quality and cost of care can be aligned.

One Year Report from the Center for Medicare and Medicaid Innovations

The One Year Report from the Center for Medicare and Medicaid Innovations (CMMI) provides a good overview of its various initiatives, including:

• Pioneer Accountable Care Organizations (ACOs). Starting on January 1, 2012, 32 organizations are participating in the Pioneer ACO Model to test what can be achieved through highly coordinated care for more than 850,000 Medicare fee-for-service beneficiaries. 
• Matching Payment to the Patient Experience—Bundled Payments for Care Improvement. Builds on episode-based payment models pioneered in the private sector by offering providers four patient-centered episode of care models to choose from.  Plans may be able to apply as “Conveners of participating health care providers.” 
• The Comprehensive Primary Care Initiative.  A collaboration between public and private payers and primary care practices to give primary care practices new, public, and private funding for primary care functions not currently supported by fee-for-service payments.
• Engaging Local Innovators—Health Care Innovation Challenge. Will award up to $1 billion in grants to applicants who put into practice the most compelling new ideas for rapidly delivering better health, improved care and lower costs to people enrolled in Medicare, Medicaid and CHIP, particularly those with the highest health care needs.

 Read the full One Year Report for more information.

Grant Opportunities

AstraZeneca 2012 Connections for Cardiovascular HealthSM program

The AstraZeneca HealthCare Foundation announced that it is accepting online applications for the 2012 Connections for Cardiovascular HealthSM program. To qualify for a Foundation grant, US-based nonprofit 501 (c)(3) or similar organizations must be engaged in charitable work in the United States that address the program's mission of improving cardiovascular health and meet key criteria. Foundation grants of $150,000 and up will be provided annually to innovative initiatives that are focused on clearly defined and measurable results and processes. The recipient organization must be able to demonstrate ongoing activity to improve cardiovascular health and the ability to sustain the initiative after the Foundation grant funds are spent.

Organizations can submit online applications for the program through Thursday, March 15 at 5:00 p.m. EST. For more information on the Foundation and how to apply for a Foundation grant, visit: http://www.astrazeneca-us.com/foundation

AMA Foundation Grants Available for Clinics to Implement Nutrition and Diabetes Programs

The American Medical Association (AMA) Foundation is accepting applications for its Healthy Communities/Healthy America program, which will award up to 11 Free Clinics with grants of $25,000 for nutrition education and awareness projects, and up to 5 grants of $10,000 for diabetes management and education projects. This program is supported by contributions from the Walmart Foundation and Lilly USA, LLC.

Letters of inquiry are due February 20, 2012. Visit www.amafoundation.org/go/clinics to view eligibility criteria and to download an application.

Updates from HCPF

Colorado Department of Health Care Policy and Financing's: At a Glance (February 2012) & CICP Newsletter (January 2012)

Something to Celebrate

Guest Blog Post by Gretchen Hammer, executive director of the Colorado Coalition for the Medically Underserved

All Kids Covered recently released Crossing the Finish Line: Achieving Meaningful Health Care Coverage and Access for All Children in Colorado. The report provides an update on the current status of meaningful health care coverage and access for children in Colorado, and describes the significant progress we have made toward getting our children the health care coverage and services they need.

The good news is that between 2008 and 2010, more than 40,000 children gained coverage, meaning that roughly 90% of kids in Colorado now have health insurance. In addition, most children in Colorado have a usual source of care ― a place where they regularly go to get their health care. We should take a moment to celebrate these great accomplishments and thank the countless people who have contributed to this progress.

Of course, there is still more work to be done. Much of the growth in coverage has come through higher enrollment in Medicaid and CHP+, which is from both policy changes to improve public programs and the economic hardships facing many Colorado families.

Additionally, the most recent estimates suggest that between 112,200 and 124,128 children in Colorado still do not have health insurance. And access to care varies across the state. While fewer than 5% of kids in the metro area, the Eastern Plains and Northwest Colorado do not have a usual source of care, nearly 1 in 13 Southwest Colorado children (7.6%) do not have a usual source of care. That’s too many!

It is not too much to ask that all of Colorado’s kids have access to the health care they need, when they need it. To build on the strong momentum of the last few years, All Kids Covered has outlined five key strategies, and we invite you to read through those on pages 15-17 of the report.

Colorado is 90% of the way there to crossing the finish line and covering all kids. It is going to take all of us working together to ensure that our children will have the coverage and care they need to have healthy and fulfilling lives.

A recorded webinar presenting the report and its findings is available online.

Institute for Healthcare Improvement (IHI) scholarships & travel support available!

Kaiser Permanente is once again providing support for lead staff at ClinicNET affiliates to participate in Institute for Healthcare Improvement conferences and trainings. In addition, they have granted ClinicNET a limited amount of funding to support travel for eligible conference attendees. Click here for a list of upcoming IHI conferences and trainings and be sure to check out the IHI website for more details. If you or another lead staff member at your clinic are interested in participating in one of the upcoming IHI offerings please email Brooke Powers at brooke.powers@clinicnet.org First come first serve!

Affordable Care Act: Opportunities for Safety Nets

The Affordable Care Act has the potential to help safety-net providers deliver more accessible, higher-quality care to vulnerable populations. Read about the provisions of the law that will help safety-net providers in a new blog post by The Commonwealth Fund. In a related blog post, the National Academy for State Health Policy explores how these providers will be affected by participation in accountable care organizations.

Also available from The Commonwealth Fund is a podcast exploring what health reform means for safety-net providers.

ICD 10 For Safety Net Providers

The Health Resources and Services Administration provides an online resource for safety net providers to learn more about the conversion of ICD-9 to ICD-10. The deadline set by the Centers for Medicare and Medicaid Services in a Final Rule (PDF-237 KB) to convert to using ICD-10 is October 1, 2013. However, prior to this date, all providers that electronically transmit data will need to convert from coding version 4010/4010A1 to version 5010 by January 1, 2012. Failure to convert and transmit data using ICD-10 codes will compromise a provider’s ability to bill for reimbursement and will also affect other activities including qualifying for quality incentive programs. This webpage provides resources on the definition of ICD-9 and ICD-10, who needs to transition, and available resources to support the transition.

Community Organizing Webinar Series

Expert community organizers will present in this webinar series on how to identify, develop, and empower leadership through organizing concepts, tools, and strategies. Classes are the 2nd & 4th Thursdays of the month, 1-2pm MT, starting in February. Participation is free and does not require pre-registration. Sign up for the learning session listserv at http://www.cfmc.org/caretransitions/learning_sessions.htm.

Dates & Topics:

• Feb 9 - Introduction to Leadership & Organizing
• Feb 23 - Public Narrative: Story of Self
• Mar 8 - Building Relationships in Organizing
• Mar 22 - Mapping Actors: Identifying & Recruiting Leadership
• Apr 12 - Structuring Effective Leadership Teams
• Apr 26 - Developing Motivating Vision & Goal
• May 10 - Developing a Campaign Timeline & Tactics
• May 24 - Call to Action: Story of Self, Us & Now

To Join:

• phone: 866.639.0744
• website: https://qualitynet.webex.com
• password: community