The Colorado Trust

COLORADO CHILDREN'S HEALTHCARE ACCESS PROGRAM RECEIVES TRUST LEADERSHIP AWARD

In presenting the award, Irene M. Ibarra, President and CEO of The Colorado Trust, said "The work of Dr. Poole and CCHAP exemplifies the ingenuity, devotion and can-do attitude necessary to move us toward caring for all children. In a short time, CCHAP has helped pediatricians and family doctors to overcome the many barriers that keep them from providing the important care that these children need."

"In 2006, one-third of Colorado's kids were in government-funded health programs," said Steve Poole, MD, CCHAP founder and director. "Yet about 140,000 children who were either enrolled in – or eligible for – Medicaid and Child Health Plan Plus (CHP+) couldn't find a medical home. That is, a primary care practice that's accessible and provides continuous, coordinated and culturally effective health care."

So Poole established the nonprofit program to enable private pediatric and family practices to devote 10% or more of their practice to publicly insured children.

"Colorado has a wonderful system of safety net providers – community health centers, school-based clinics, hospital-based clinics and so on – but they can't meet the demand alone," said Poole, who also serves as Professor and Vice Chair, Department of Pediatrics for the School of Medicine, University of Colorado, and is a clinical team member at The Children's Hospital. "We interviewed physicians to learn what the barriers were to participating in Medicaid and CHP+. Among many factors, barriers include low reimbursement rates, problems with claims processing and not knowing how to provide culturally-sensitive care to children from ethnically diverse families."

CCHAP partnered with the Colorado Department of Health Care Policy and Financing, Rocky Mountain Health Plans and Colorado Access to enhance provider reimbursements that promote and reward comprehensive, preventive care. They work closely with primary care providers offering administrative supports – such as assistance with eligibility and enrollment-related issues of Medicaid and CHP+ – that allow physicians to see more publicly insured children.

"So far, we've worked with pediatric providers in 15 counties along the Front Range and Summit County," Poole said. "In 2006, only 20% of pediatricians along the Front Range would provide care for children covered by these programs. CCHAP now supports 90% of these practices, serving approximately 60,000 low-income children."

Preliminary results show that pediatric and family medical practices participating in CCHAP have cut in half the emergency room visits of the publicly insured children they see, and have achieved other costs savings with an increased focus on well-child visits and preventive care. These savings are used to provide higher reimbursements to doctors, making it possible for them to see increasing numbers of publicly insured children. Additionally, CCHAP has linked the participating practices to an array of services for families provided by 30 community-based organizations, for example, mental health counseling, social services, transportation, case management and an immunization reminder system.

CCHAP is now turning its attention to helping family practices across the remainder of the state to enroll and serve eligible children. "Our goal is to work ourselves out of a job by helping community-based organizations, and county and state agencies to pick up the responsibility to support private practices across the state in enrolling and serving eligible children in all Colorado counties," said Poole. "But there's still much work to be done. Every year, about 30,000 women deliver a child eligible for CHP+ or Medicaid. Without access to a medical home, these kids are at risk."

The Colorado Trust Grantee Leadership Award was created in honor of John R. Moran, Jr.'s dedication to advancing the health and well-being of the people of Colorado. Moran is the former long-time President and CEO of The Colorado Trust. For more information about The Colorado Trust's support of CCHAP to help improve the state's health systems, contact Deidre Johnson, Program Officer, 303-837-1200, deidre@coloradotrust.org.