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Colorado Health Care Snapshot. Source of Insurance Numbers in Thousands
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1. Financing the Patient-Centered Medical Home: Making the Investment in Primary Care
Sandeep Wadhwa, MD, MBA
Medicaid Director and Chief Medical Officer
State of Colorado
October 2008
2. Colorado Health Care Snapshot
3. Medical Services PremiumsCaseloadFY 07-08 ADD ACTUAL CASELOAD NUMBERS DOWN HEREADD ACTUAL CASELOAD NUMBERS DOWN HERE
4. Medical Services PremiumsPer Capita CostFY 07-08
5. State’s Role in Primary Care Reform Legislative/regulatory authority
Catalyst for encouraging public/private collaboration
Active participant in the community of payers
Dominant payer for safety net Presentations are available on-linePresentations are available on-line
6. Financing Primary Care Reform Medicaid - Phase 1 Repurposed our EPSDT care coordinators to support Medical Home objectives
Increased EPSDT payments to further cover Medical Home activities
Regional ASO with 50% shared savings with primary care physicians Presentations are available on-linePresentations are available on-line
7. Financing Primary Care Reform Medicaid - Phase 2 Care management PMPM fee for medical home providers
Care coordinator and health educator layer - community and office based
Move from shared savings to shared outcome incentives (ambulatory care sensitive conditions hospitalizations, emergency room visits) Presentations are available on-linePresentations are available on-line
8. State Based Primary Care Reform Participate in multi-payer collaborative
Created public-private value- based healthcare center to collaboratively address structuring/financing of primary care Presentations are available on-linePresentations are available on-line
9. Thank you Sandeep Wadhwa, MD
sandeep.wadhwa@state.co.us