Presentation from the Dept. Health Care Policy and Financing
INTERIM COMMISSION TO STUDY FISCAL STABILITY
10:06 AM -- Presentation from the Department of Health Care Policy and Financing on Health Care Issues
Joan Henneberry, Executive Director for the Department of Health Care Policy and Financing (HCPF), began by discussing the department's mission and the public health care programs administered by the department, such as Medicaid and the Children Basic Health Plan. A copy of the department's power point presentation is provided as Attachment B.
Ms. Henneberry continued by noting that since the department is such a large purchaser of health care it influences the health care market for all of Colorado. She discussed the Medicaid program and explained that cuts in state funding for the program result in foregone federal matching funds. She stated that Colorado's program is considered "lean" because the state has not chosen to add as many optional services or expanded eligibility criteria as much as other states. Currently, about 10 percent of Coloradans are enrolled in public health insurance programs.
Ms. Henneberry discussed the benefits of the state's usage of "waiver" programs that allow the department to serve populations that are ordinarily ineligible for public assistance.
Mr. John Bartholomew, Chief Financial Officer, HCPF, discussed the state's utilization of the federal stimulus money from the American Recovery and Reinvestment Act (ARRA) for its Medicaid program. The ARRA money results in the federal government increasing its matching funds to the state. He also discussed the various types of populations served by public health insurance in the state and the costs for serving them. The most costly are the elderly and disabled population, though children and adults represent the largest population served. He also provided information on HCPF's budget, noting the relatively small share for administration costs.
Ms. Henneberry discussed HCPF's efforts to be more cost effective, including the use of outside contractors to provide services. The department uses performance metrics to help ensure accountability and quality for the services it administers through contracted providers. She also discussed the department's efforts to deal with fraud and abuse within the public health system.
Mr. Robert Douglas, acting legal division director for HCPF, discussed HCPF's efforts to recover funds paid out for services that the state was not legally required to pay.
Ms. Henneberry discussed the increase in Medicaid caseload during recessions and its impact on the budget. ARRA has helped the state in meeting the increase in demand for services. The ARRA funding expires in December of 2010.
Mr. Renny Fagan, commission member and head of the Colorado Nonprofit Association, inquired about ways to reduce costs for serving the elderly and disabled populations and projections for the increase in caseloads for these populations. Ms. Henneberry discussed ways to reduce the costs for serving the elderly and disabled, such as by utilizing case managers to better coordinate and integrate the care provided to them. She also stated that home- and community-based services can help reduce costs. However, a lack of affordable housing and transportation for the elderly and disabled are barriers to increasing the use of such services.
The commission discussed the costs to the state of funding nursing home care and issues surrounding clients' sheltering of assets which are used to help determine their costs for services. Ms. Henneberry provided information on the state's efforts to better coordinate funding services to clients under both Medicare and Medicaid in order to save money.
The commission discussed House Bill 09-1293 (Health Care Affordability Act of 2009) and its impact on the state budget and increasing health coverage to the uninsured.
Representative Lois Court commented on the need to assess what level of health care services the state should provide and the costs for these services. Ms. Henneberry discussed the needs of the state's health care system, both public and private. She commented on the eligibility tests for public insurance programs and the high costs of health care. Mr. Bartholomew provided statistics on the costs of serving different populations under public insurance programs.
In response to the commission's questions, Ms. Henneberry provided information on providers' efforts to provide preventative health care services and chronic disease management to reduce health care costs. She also noted the Department of Public Health and Environment's programs involving preventative health care and wellness education.
The commission discussed HB 09-1293 and requested various pieces of information from HCPF, such as the department's ways of measuring performance, the CoverColorado program, and caseload costs over the business cycle. Ms. Henneberry indicated that HB 09-1293 included an oversight committee to look at the impact of the bill on hospitals and cost shifting.