Issue Position: Health Care

Issue Position

The goal of health care policy is to ensure access to health care, while reducing costs, and without sacrificing quality or patient safety. We have a unique opportunity to become a healthier state while at the same time reducing costs and increasing job opportunities. The explosive increases in medical costs have put a strain on Colorado families, businesses and the state budget. In 2008, health insurance premiums represented nearly 22 percent of median family income. In the past decade, costs grew at twice the rate of the average increase in wages; at this rate, the cost of family insurance will reach $27,000 or more in the next decade. This restrains job growth, reduces the discretionary incomes of our families and makes it increasingly challenging for our state to adequately fund other critical services. It also means that hundreds of thousands of Colorado families and children are unable to afford basic health services.

Colorado families pay the seventh highest insurance premium costs in the nation. We also have the 15th highest rate of uninsured people. The fact is, uninsured people don't get health care. If you don't have access to health care, it is hard to stay healthy. As Colorado employers and state government reduce their share of health care costs, consumers are seeing their benefits and coverage slashed. This results in an increase in uncompensated care and places an additional cost burden on those who remain covered.

Strategies and Solutions

Cost efficiency and quality improvement go together. We understand the importance of increasing efficiencies and effectiveness while improving high quality care. For example, Denver coordinated efforts that increased efficiency, improved quality and saved nearly $42 million for Denver Health and Hospitals.

Healthy Kids, Healthy Lifestyles and Prevention

We must support healthy lifestyles that prevent and combat childhood obesity, diabetes and other chronic diseases, whose incidence and severity are brought on by unhealthy behaviors. We will support innovative programs that incentivize individuals to reduce their health risks, thus saving money for consumers, hospitals, and insurers. We can bring the private sector (health care providers and insurers) into better collaboration with school districts to increase public awareness (particularly with our kids) about healthier diets and exercise.

Information and Transparency

Electronic medical records, all-payer databases, and regional health information organizations are proven to generate more accurate and timely information. These coordinated information systems can be utilized by the private and public sector in both urban and rural environments to increase efficiencies and value, thus benefitting consumers, providers, insurers, and businesses alike while at the same time eliminating fraud wherever possible. We support their implementation.

Value-Based Purchasing

We must become a more effective health care purchaser for those eligible for benefits through state-sponsored programs like Medicaid and the state employees' health program, as well as through other publically funded health insurance such as school districts. Value-based purchasing includes evaluation of benefits, reduction of variations in care, reduction of avoidable readmissions, use of clinical protocols, increased transparency of information on costs and quality, and payment reforms that reward quality.

Restructuring Delivery of Care

Colorado is fortunate to have models across the state of integrated care and federally qualified health centers (FQHCs) that are renowned nationally and prove the value of experimentation and awareness that one size does not fit all. From Greeley and Alamosa, to Grand Junction and Denver, these systems serve as models of health care delivery by promoting primary care and providing medical homes for individuals, thus reducing utilization of emergency departments and hospital admissions. They more effectively manage chronic disease, promote the health of the population, and aggressively manage costs. We will encourage these kinds of proven approaches by supporting demonstration projects and grants under Medicaid, Children's Health Insurance Program (CHIP), and Medicare to facilitate greater care coordination and delivery system integration.

Positioning Colorado in the Aftermath of Federal Health Care Reform

Colorado is well positioned to implement federal reform based on the bipartisan blueprint created by the Commission on Health Care Reform, the establishment of the Center for Improving Value in Health Care, and the Colorado Health Care Affordability Act. With the passage of reform at the national level, we will work to implement insurance market reforms, insurance exchanges, public program expansions, delivery system reforms, prevention and wellness programs, and fraud and abuse audits as outlined by the federal mandate. It is more important than ever that Colorado establish an effective partnership with key federal agencies for grant funding and to optimize matching funds for programs for the disabled, children and low income parents and children.

Administrative Efficiency

Studies show that as much as 30 percent of the cost of health services is spent on administrative processes. Together with the Colorado legislature and the health care community, we will facilitate simplified administrative procedures for state-run public programs and the private sector through the standardization of coding, billing and payment, for physicians, hospitals, and health plans.

Education and Labor Force Development

We will continue to support the education and training of health professionals to assure that Colorado, in particular the rural parts of the state, has an adequate supply of high-quality primary care physicians, nurses and allied personnel. We will work together to develop innovative and cost-effective approaches to education such as increasing broadband distribution to facilitate online training.

Rural Health care

Our rural communities face unique challenges accessing affordable health care, such as limited financial resources and an inadequate supply of skilled personnel. In order to begin to improve the quality and availability of care in these communities, we will explore telemedicine, tele-health and other technological advancements, including expanding broadband access through public structures already begun in the Owens and Ritter administrations, but not yet realized.

Mental Health

Colorado has the lowest number of psychiatric beds per capacity of any state in the nation, yet we have the sixth highest suicide rate in the nation. We will assemble experts in the mental health community to determine best practices that can be implemented statewide and identify opportunities for federal drawdown of funds specific for mental health services.

Collaboration

We will create partnerships with private health care providers to develop a comprehensive information infrastructure, standardized administrative processes, and common approaches to value-based purchasing. As important, we will align the policies of the Departments of Insurance, Health Policy and Financing, Public Health and Environment and Health and Human Services to assure that resources allocated to improve health and provide health care are appropriately and strategically deployed, coordinated, and managed.

The implementation of these strategies will not occur with a stroke of a pen. Rather, we will serve as the catalyst, bringing together the diverse health care community to identify best practices, new ideas and solutions, current research, and economies of scale. This effort is one we believe will pay off in both the fiscal health of our state and the personal health of our residents. As people become healthier, it costs us all less money, and excellent health care attracts new businesses. It is time that we all work toward to create a healthier state by creating more effective and efficient service delivery systems and by generating more value for our health care dollar.

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