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Maintaining good health requires access to care when it is needed. Yet, care is more difficult to find for some Coloradans because of where they live or their ability to pay. Achieving coverage for 800,000 uninsured Coloradans will place increased demands on a health care system that already struggles to deliver quality care in all areas of the state. With economic conditions threatening the survival of safety-net providers, such as school-based clinics and community health centers, there is an immediate need to maintain the viability of health care delivery sites and providers to serve low-income children and families. A systemic, longer-term fix also is needed to ensure that sufficient numbers of providers are trained in primary care and needed specialties, and recruited and retained in underserved areas. Distance and geographic barriers often limit rural Coloradans' ability to reach health care facilities. According to the Colorado Rural Health Center, 13 of Colorado's 64 counties do not have a hospital, 28 have no community health center and three are without local health care resources of any kind. Urban and suburban communities also face significant challenges with many healthcare facilities that serve low-income populations operating at capacity, leaving patients with long delays for appointments. Because of poor reimbursement, administrative hassles and other factors, many private providers limit the number of publicly insured people they are willing to serve, even as the number of uninsured and publicly insured Coloradans has grown during the economic recession. According to the Commonwealth Fund State Scorecard (2007), just over half of Colorado children (57.7%) received both a preventive medical and dental visit in 2003. The Colorado Children's Healthcare Access Program (CCHAP) is helping to increase the availability of care for publicly insured children. With support from The Trust, CCHAP has helped to increase from 20% to 90% the number of Front Range pediatric and family medical practices that care for children enrolled in Medicaid and Colorado Health Plan Plus (CHP+). 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 cost 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 more children covered by Medicaid and CHP+. CCHAP is now poised to help provide needed medical homes to children in underserved areas across the state. |
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