Recent reports by the Kaiser Family Foundation and the Goldman Sachs Group estimate Coloradans could be in line for millions of dollars in rebates from health insurance issuers for comprehensive major medical health insurance premiums, required by the Patient Protection and Affordable Care Act (PPACA). Beginning in 2011, the law required health insurance issuers in the small group and individual markets to spend 80 percent of premiums on health care costs; those in the large group market are required to spend 85 percent on health care costs. This is known as the Medical Loss Ratio (MLR) rule. Health insurance issuers that fail to reach that threshold are required to pay rebates. The Colorado Division of Insurance wants consumers to know that the information in the reports is an estimate, based on data submitted in annual financial filings to the National Association of Insurance Commissioners (NAIC), and the final calculations in the reports include a number of assumptions. Data upon which the actual rebates will be based will be submitted to the U.S. Department of Health and Human Services (HHS) by June 1, 2012. HHS will then make the final determination regarding rebates, and issuers will pay out those rebates on August 1, 2012.
Colorado selected as one of seven markets nationwide to participate in a federal Comprehensive Primary Care Initiative. Under this program, select primary care practices will receive enhanced payments to provide additional services to patients, including: care coordination; increasing patients' access to care; delivering preventive care; engaging patients and caregivers in managing their own care; and providing individualized, enhanced care for patients living with multiple chronic diseases and higher needs.
Colorado received $3.7M grant to improve the health and development of children and provide early childhood supports and home visits to families who volunteer to receive these services. This award is part of the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) and will give Colorado a significant boost in our efforts to keep children safe and healthy.
Since 2010, 29 Colorado companies have received almost $44.3 million to help reduce health insurance costs and ensure continued coverage for early retirees not yet eligible for Medicare. Nationwide, 13 million Americans aged 55-64 benefitted from $4.73 billion in assistance through the Early Retiree Reinsurance Program (ERRP), a federal program established by PPACA. Read more about ERRP’s success here.
The Department of Health Care Policy and Financing (HCPF) wants your ideas on implementing health care reform in Colorado. HCPF is identifying changes to Medicaid and CHP+ eligibility systems, training, communication, and practices, and every Friday they will post specific topics on which feedback may be provided for 7 days. Your ideas will help HCPF formulate a plan that will be submitted to the Centers for Medicare and Medicaid Services (CMS) to request enhanced federal funding to implement these changes. To see HCPF’s official letter requesting stakeholder feedback, please click here. To share your ideas, click here.
This Kaiser Family Foundation tool shows people what proportion of their community will benefit from PPACA’s coverage expansions. Check out your zip code here.
Understanding the Individual Mandate: Kaiser Family Foundation has developed a simple flowchart to help people understand health reform’s requirement for many to purchase health insurance coverage starting in 2014.
Family Voices Colorado recently announced the launch of the Colorado Resource Directory, an online resource guide for families and professionals working with children or adults with special health care needs.
On Wednesday, January 18, the Colorado Division of Insurance and the Colorado Health Benefit Exchange will co-host a stakeholder meeting to address the recent HHS bulletin regarding Essential Health Benefits. Additional information available here.
Denver-based Physician Health Partners was selected as one of only 32 participants nationwide in the Pioneer Accountable Care Organization Payment Reform Project, which will test the impact of innovative payment arrangements to achieve better care and outcomes at a lower cost. Additionally, 4 Coloradans were selected from over 900 applicants to participate in HHS’s Innovation Advisors Program. They include Ms. Erin Denholm, Centura Health; Dr. Daniel Johnson, Kaiser Permanente; Dr. Candice Lagasse, United States Air Force (Buckley AFB); and Dr. Jay Want, Center for Improving Value in Health Care.
Colorado Health Benefit Exchange's Level One Establishment Grant
HHS announced Friday that states will decide what essential benefits must be covered by insurance starting in 2014. Each state will choose from several existing plan structures, including plans offered to state and federal employees, HMO plans, and small group plans. The ACA requires every plan to cover, at a minimum, preventive care, emergency services, pediatric care (including oral and vision), maternity care, hospital and physician services, and prescription drugs. The Essential Health Benefits Bulletin can be found at http://cciio.cms.gov/resources/files/Files2/12162011/essential_health_benefits_bulletin.pdf
The Legislative Implementation Review Committee voted 9-1 to approve the submission of the Colorado Health Benefit Exchange's Level One Establishment Grant application by Dec. 31 to the U.S. Department of Health and Human Services. If approved, the nearly $18 million grant will fund the next phase of establishing the new state health insurance marketplace, which is scheduled to open for business in late 2013.
The new 2011 Colorado Health Access Survey (CHAS) has been released. It is a statewide survey that focuses on Coloradans’ access to care, usage of health care services, and affordability.
The Colorado Health Benefit Exchange has launched their new website, www.getcoveredco.org.
- Join Colorado Commissioner of Insurance, Jim Riesberg, to learn the latest information about changes in your health insurance
- http://bit.ly/vTesnc
- Upcoming 2011 Meetings
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Exchange Board Meetings
September 16, 26 9:30am - 1:30pm
Mile High Room of COPIC
7351 E. Lowry Blvd, Denver, CO, 80230Beginning October 10, 2011, the Board will meet the 2nd and 4th Monday of each month from 8:30 am - 12:00 pm in the Mile High Room of COPIC. This schedule will remain through the end of 2012. Holiday and other conflicts may change the schedule periodically.
- June 10, 2011
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Colorado Health Benefit Exchange Board of Directors Inaugural Meeting
July 11, 2011 10:30 - 1:30
(Lunch will be provided for board members at 12:30)
225 16th Avenue, Denver, CO
1st Floor Conference Room - May 19, 2011
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The state is seeking volunteers to help design evidence-based outreach and education materials for the uninsured. The committee will be co-chaired by the Department of Health Care Policy & Financing and the exchange planning grant staff. We will hold our first meeting mid-June to discuss current efforts, what we will need going forward, and ways to coordinate with other organizations and existing initiatives. If you are interested in being part of the workgroup that will meet monthly starting in June, please email henneberryj@coloradohealthinstitute with your contact information.
- March 18, 2011
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The Patient Protection and Affordable Care Act (ACA), authorizes the establishment of "American Health Benefits Exchanges" ("Exchanges") in each state. Exchanges will provide a new marketplace for individuals and small employers to shop for and enroll in both public and private health insurance coverage. CHI is seeking to procure assistance with the research and development of a comprehensive report detailing the current state of health insurance coverage in Colorado, and critical details about the existing health insurance marketplace (...more)
