Transcript Department of Health Care Policy and Financing COLORADO HEALTH REFORM IMPLEMENTATION October 2012

Department of Health Care Policy and Financing
COLORADO HEALTH REFORM IMPLEMENTATION
October 2012
Department of Health Care Policy and Financing
HEALTH IN COLORADO
Improve health care access and outcomes for the people we serve while
demonstrating sound stewardship of financial resources.
Department of Health Care Policy and Financing
INSURANCE REFORMS
2010
Dependent
Insurance
Accountability
care coverage for adult
children to age 26
No pre-existing conditions
exclusions for children
No lifetime limits
No rescissions
Medical Loss Ratio to 80% ind.
market and 85% large group market
(2010 reporting, 2011 rebates)
Free preventive care (new plans)
Begin phase out of annual limits
2014
No
annual limits
Guaranteed issue
Guaranteed renewability
No gender rating
No health status rating
Age rating 3:1; Geographic
variation/tobacco rating 1.5:1
Improve health care access and outcomes for the people we serve while
demonstrating sound stewardship of financial resources.
Department of Health Care Policy and Financing
COVERAGE
Coverage
Improve health care access and outcomes for the people we serve while
demonstrating sound stewardship of financial resources.
Department of Health Care Policy and Financing
MEDICAID AND SUPREME COURT
•
Improve health care access and outcomes for the people we serve while
demonstrating sound stewardship of financial resources.
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Department of
of Health
Health Care
Care Policy
Policy and
and Financing
Financing
Department
WHAT IS A HEALTH BENEFIT EXCHANGE?
Improve health care access and outcomes for the people we serve while
demonstrating sound stewardship of financial resources.
Department of Health Care Policy and Financing
Department of Health Care Policy and Financing
SB11-200: CO HEALTH BENEFIT EXCHANGE ACT OF
2011
Improve health care access and outcomes for the people we serve while
demonstrating sound stewardship of financial resources.
Department of Health Care Policy and Financing
BENDING THE COST CURVE
Cost
Containment
Improve health care access and outcomes for the people we serve while
demonstrating sound stewardship of financial resources.
Department of Health Care Policy and Financing
Accountable Care Collaborative
Regional Care
Collaborative
Organizations
Build provider network; support
PCMPs with practice support &
care coordination
Primary Care Medical
Providers
PCMPs
Medical homes for clients
Statewide Data
and Analytics
Contractor
SDAC
Gives client
utilization data and
program
performance data to
PCMPs and RCCOs
Improve health care access and outcomes for the people we serve while
demonstrating sound stewardship of financial resources.
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Department of Health Care Policy and Financing
Room for Experimentation: HB 1281
Courtesy: Colorado Health Institute
Improve health care access and outcomes for the people we serve while
demonstrating sound stewardship of financial resources.
Department of Health Care Policy and Financing
Long Term Services and Support
Improve health care access and outcomes for the people we serve while
demonstrating sound stewardship of financial resources.
Department of Health Care Policy and Financing
FOCUS ON BUSINESS
Improve health care access and outcomes for the people we serve while
demonstrating sound stewardship of financial resources.
Department of Health Care Policy and Financing
EMPLOYER FLOW CHART
Improve health care access and outcomes for the people we serve while
demonstrating sound stewardship of financial resources.
QUESTIONS & ANSWERS
Sue Birch
Executive Director
Health Care Policy and Financing
[email protected]
colorado.gov/healthreform