co.us/ps/hcp/medicalhome/providers/CCHAP%20

Colorado Children’s Healthcare Access Colorado Children’s Healthcare Access ProgramProgram

A Medical Home For Every ChildA Medical Home For Every Child

A Non-Profit OrganizationA Non-Profit Organization

180,000 Medicaid/CHP+ enrolled 180,000 Medicaid/CHP+ enrolled or eligible children in Colorado or eligible children in Colorado are not able to access a medical are not able to access a medical homehome

Lewin and Associates, Dept. of Health Care Policy and Lewin and Associates, Dept. of Health Care Policy and Financing, Colorado Children’s Campaign, Colorado Health Financing, Colorado Children’s Campaign, Colorado Health Institute. 2008Institute. 2008

Health Care for Low Income Children Health Care for Low Income Children in Coloradoin Colorado

At least 30,000 new eligible At least 30,000 new eligible children a year.children a year.

In early 2005, only 20% of In early 2005, only 20% of Colorado private practice Colorado private practice pediatricians and family pediatricians and family physicians accepted physicians accepted Medicaid and CHP+Medicaid and CHP+

IF………IF………

All pediatric practices devote 15% of All pediatric practices devote 15% of their practice to Medicaid and CHP+ their practice to Medicaid and CHP+ , then 96,000 children can get a , then 96,000 children can get a medical homemedical home

If all family physicians who see If all family physicians who see children devoted 15% of their child children devoted 15% of their child population to Medicaid and CHP+, population to Medicaid and CHP+, then another 40,000 children can get then another 40,000 children can get a medical home.a medical home.

Surveys of Primary Care Surveys of Primary Care PhysiciansPhysicians Barriers To Accepting Barriers To Accepting

Medicaid/CHP+ Children:Medicaid/CHP+ Children:1.1. Inadequate reimbursementInadequate reimbursement2.2. Families have many social issues that create barriers Families have many social issues that create barriers

to care (need a social worker)to care (need a social worker)3.3. Poor access to mental health servicesPoor access to mental health services4.4. Medicaid/CHP+ processes cumbersomeMedicaid/CHP+ processes cumbersome5.5. Difficulties with enrollment, disenrollmentDifficulties with enrollment, disenrollment6.6. Need case management supportNeed case management support7.7. Need help in improving immunization rates Need help in improving immunization rates 8.8. Need help to reduce inappropriate ED utilizationNeed help to reduce inappropriate ED utilization9.9. Assistance for families that lack transportationAssistance for families that lack transportation10.10. A support and advice system for practicesA support and advice system for practices11.11. Practices need to improve skills in relating to diverse Practices need to improve skills in relating to diverse

culturescultures12.12. Help for families with limited English proficiencyHelp for families with limited English proficiency13.13. Need help with no-shows (missed appointments)Need help with no-shows (missed appointments)14.14. Need help in understanding resources available for Need help in understanding resources available for

chronically ill children and low-income families chronically ill children and low-income families

Colorado Children’s Healthcare Access Colorado Children’s Healthcare Access Program (CCHAP)Program (CCHAP)

A Non-Profit OrganizationA Non-Profit Organization

MissionMissionTo ensure that every Medicaid and CHP+ To ensure that every Medicaid and CHP+ child in Colorado receives comprehensive child in Colorado receives comprehensive healthcare from a primary care provider - a healthcare from a primary care provider - a “medical home.”“medical home.”

GoalGoal To help Colorado private family practices and To help Colorado private family practices and

pediatric practices to provide health care for pediatric practices to provide health care for Medicaid and CHP+ children. Encourage and Medicaid and CHP+ children. Encourage and enable these practices to devote between 10 enable these practices to devote between 10 and 20% of their practice to the care of and 20% of their practice to the care of Medicaid and CHP+ children.Medicaid and CHP+ children.

CCHAPCCHAP

Provides 16 support services for practicesProvides 16 support services for practices Working with HCPF, CDPHE, county Working with HCPF, CDPHE, county

agencies and programs, community agencies and programs, community organizationsorganizations

Linking county agencies, community Linking county agencies, community groups and practicesgroups and practices

Shifting responsibility for providing Shifting responsibility for providing support services to county, state, support services to county, state, community organizations, agencies and community organizations, agencies and programs.programs.

Administrative Supports Administrative Supports Enhanced Provider Reimbursement Enhanced Provider Reimbursement

Enrollment Specialist And Help With Enrollment Specialist And Help With Enrollment And EligibilityEnrollment And Eligibility. .

Help To Streamline Administrative Help To Streamline Administrative Processes Processes

Practice Administrators NetworkPractice Administrators Network

Family SupportsFamily SupportsSocial Services Support Social Services Support Improved Mental Health Services Improved Mental Health Services Case Management/Care CoordinationCase Management/Care Coordination

Asthma educationAsthma educationNo-showsNo-showsED utilization ED utilization

Immunization Registry And Reminder Immunization Registry And Reminder RecallRecall

TransportationTransportationDiversity Training For PracticesDiversity Training For PracticesMedical Spanish Interpretation Courses Medical Spanish Interpretation Courses After-hours telephone care After-hours telephone care Quality Improvement CoachingQuality Improvement CoachingProvider Hotline – to identify all available Provider Hotline – to identify all available

services for chronically ill childrenservices for chronically ill children

ReimbursementReimbursement

Higher reimbursement to reward Higher reimbursement to reward effective preventive care for CCHAP-effective preventive care for CCHAP-affiliated practicesaffiliated practices

Illness visits – Illness visits –

Increased from 65% of RBRVSIncreased from 65% of RBRVS

to 90% RBRVS for all providersto 90% RBRVS for all providers

Developmental screening increased to Developmental screening increased to $34$34

CollaborationsCollaborations Colorado Department of Health Care Policy and Finance Colorado Department of Health Care Policy and Finance

(Medicaid)(Medicaid) Behavioral Health IncorporatedBehavioral Health Incorporated Foothills Behavioral HealthFoothills Behavioral Health Mental Health Center of DenverMental Health Center of Denver County mental health centersCounty mental health centers MetNet MetNet Colorado Access Colorado Access University of Colorado School of Medicine Department of University of Colorado School of Medicine Department of

PediatricsPediatrics UCSOM Department of Child PsychiatryUCSOM Department of Child Psychiatry UCSOM, Division of Pediatric Pulmonary MedicineUCSOM, Division of Pediatric Pulmonary Medicine Denver Samaritan Counseling CenterDenver Samaritan Counseling Center University of Denver, Daniels School of BusinessUniversity of Denver, Daniels School of Business University of Denver School of Social Work.University of Denver School of Social Work. The Children’s Hospital (TCH) After Hours Telephone Care The Children’s Hospital (TCH) After Hours Telephone Care

Program Program The TCH Emergency Department and Urgent Care Centers The TCH Emergency Department and Urgent Care Centers University Of Colorado School Of Medicine’s Cultural University Of Colorado School Of Medicine’s Cultural

Competency ProgramCompetency Program Colorado Immunization Coalition and the Immunization Colorado Immunization Coalition and the Immunization

RegistryRegistry Colorado Health Outcomes ProgramColorado Health Outcomes Program Colorado Health InstituteColorado Health Institute

CollaborationsCollaborations School of Medicine - DeanSchool of Medicine - Dean Safety Net Providers: Safety Net Providers: Colorado Community Health NetworkColorado Community Health Network ClinicNetClinicNet Denver Health,Denver Health, Rocky Mountain Youth,Rocky Mountain Youth, MCPNMCPN Colorado Chapter of the American Academy of Pediatrics Colorado Chapter of the American Academy of Pediatrics LogisticareLogisticare Colorado Foundation for Families and ChildrenColorado Foundation for Families and Children EPSDT office at HCPFEPSDT office at HCPF EPSDT program county outreach workersEPSDT program county outreach workers State Department of Public Health and EnvironmentState Department of Public Health and Environment (Medical Home Division)(Medical Home Division) County public health nursesCounty public health nurses International Language Services, International Language Services, Family Voices Family Voices State Network of Colorado Ambulatory PracticesState Network of Colorado Ambulatory Practices

Funding For CCHAPFunding For CCHAP

Piton FoundationPiton Foundation The Colorado Health FoundationThe Colorado Health Foundation Rose Community FoundationRose Community Foundation Caring For ColoradoCaring For Colorado Amer Chair in Community PediatricsAmer Chair in Community Pediatrics Colorado Trust Colorado Trust Community Child Health FoundationCommunity Child Health Foundation The Denver FoundationThe Denver Foundation

Percent of Private Pediatric Percent of Private Pediatric Practices Practices

Affiliated with CCHAP by Affiliated with CCHAP by RegionRegion

Colorado Springs – not oriented yet, but docs say Colorado Springs – not oriented yet, but docs say they are interested. In final stages of recruitmentthey are interested. In final stages of recruitment

CCHAP Providers and Practices by Region

66%

75%

68%

73%72%

58%

60%

62%

64%

66%

68%

70%

72%

74%

76%

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Denver

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South

Fro

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Springs

East

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% o

f 100

% CCHAPProviders

%CCHAPPractices

Waiting list of 30 family Waiting list of 30 family practices around the statepractices around the state

Long Term SustainabilityLong Term Sustainability We start with support services We start with support services

provided by CCHAP, paid for by provided by CCHAP, paid for by foundationsfoundations

We work closely with state and We work closely with state and county agencies and community county agencies and community organizations to shift all supports to organizations to shift all supports to them for long term sustainability. them for long term sustainability. Working well.Working well.

We create written agreements with We create written agreements with the community organizations and the the community organizations and the counties to make this sustainablecounties to make this sustainable

New DirectionsNew Directions Colorado Trust grant to assess Colorado Trust grant to assess

the needs of low-income children the needs of low-income children in under-served counties and the in under-served counties and the availability of medical homes. availability of medical homes. We are establishing a task force We are establishing a task force to make recommendations to make recommendations regarding how best to create regarding how best to create enough medical homes. Will enough medical homes. Will work closely with Colorado work closely with Colorado Medical Home Initiative Task Medical Home Initiative Task ForcesForces

New DirectionsNew Directions Beginning to conduct a needs Beginning to conduct a needs

assessment of Colorado’s low-income assessment of Colorado’s low-income pregnant women (30,000 / yr)pregnant women (30,000 / yr)

Tracy Johnson, PhD is conducting the Tracy Johnson, PhD is conducting the analysisanalysis

Task Force will review data / analysis Task Force will review data / analysis and make recommendation to and make recommendation to governmental agencies, community governmental agencies, community organizations and foundationsorganizations and foundations

Will work closely with Colorado Medical Will work closely with Colorado Medical Home Initiative Task ForcesHome Initiative Task Forces

CCHAP.orgCCHAP.org

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