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A Medical Home For Every Child

Mission

The Colorado Children’s Healthcare Access Program is a non-profit organization  devoted to ensuring that every child enrolled in Medicaid and the Child Health Plan Plus (CHP+) receives comprehensive healthcare from a primary care provider—a “medical home.”


Background Information 

There are approximately 180,000 children in Colorado, either enrolled in or eligible for Medicaid and
CHP+, who are unable to find a medical home.

Colorado has a strong public health system, but it does not have the capacity to address this problem.
A survey conducted by the Colorado Children’s Healthcare Access Program found that only 20% of private
pediatricians and family physicians accepted Medicaid or CHP+ in 2006. The survey identified the
following barriers to private physicians participating in these government-funded health programs:

 

  1. poor reimbursement
  2. difficulties with eligibility and enrollment
  3. problems with claims processing
  4. the need for social service support for the families
  5. poor access to, and coordination of, mental health services
  6. need for better case management and care coordination
  7. trouble getting children in for regular preventive care, including immunizations
  8. transportation problems in low-income families
  9. the need to learn more about culturally sensitive and responsive care
  10. difficulty in obtaining and affording interpreters for healthcare visits.
  11. the need for help in identifing all of the resources these children are eligible for

 

Collaborating Community Organizations
American Academy of Pediatrics, Colorado
   Chapter
Behavioral Health Organizations:
   Colorado Access
   Behavioral Healthcare Inc.
   Foothills Behavioral Health
CENTUS Counseling, Consulting and
   Education
ClinicNet
Colorado Access (for CHP+ physical health)
Colorado Community Health Network
Colorado Department of Health Care Policy
   and Financing (Medicaid)
Colorado Department of Public Health &
   Environment, Medical Home Division
Colorado Foundation for Families & Children
Colorado Health Institute
Colorado Health Outcomes Program
Colorado Immunization Coalition and The
   Immunization Registry
County mental health centers
County public health nurses
Department of Child Psychiatry, UCHSC
Department of Pediatrics, UCHSC
EPSDT program, county outreach workers
Family Voices
International Language Services
Logisticare
MetNet
Rocky Mountain Health Plans
Rocky Mountain Youth
The Children’s Hospital
The Children’s Hospital Emergency
   Department and Urgent Care Centers
University of Colorado School of Medicine,
   Dean’s Fund
University of Colorado School of Medicine’s
   Cultural Competency Program
 
Funding Sources
Amer Chair in Community Pediatrics,
   The Children’s Hospital
Caring for Colorado Foundation
Colorado Health Foundation
Colorado Trust
Community Child Health Foundation
Rose Community Foundation
The Piton Foundation
 
For more information, contact:
Steve Poole, MD,
13123 E. 16th Avenue, B085,
Aurora, CO 80045
 
720-777-6004 • mailto:SPoole@tchden.org
 
Healthcare professionals,  www.cchap.org

A project of the Colorado Non-Profit Development Center

 

Pilot Program
 

Two physicians at the University of Colorado School of Medicine, Steven Poole and James Todd, developed the Colorado Children’s Healthcare Access Program (CCHAP) to address the barriers physicians cited to serving children in the Medicaid and Children’s Health Plan programs. After a year of planning, an 18-month pilot program was conducted with 7,000 children in seven pediatric practices in metro Denver during 2005–06. There were two keys to the success of the pilot program. First, CCHAP negotiated an enhanced reimbursement rate for the physicians through the managed care organization, which recognized that it would save money through reduced emergency room and hospitalization costs for the children.
 

Second, CCHAP linked the private 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.

Pilot Program Results
 

The evaluation of the pilot program has shown that private pediatric practices in Colorado are able and willing to provide a medical home for Medicaid and CHP+ children resulting in

  • Reduced cost of care per child;
  • Improved health outcome measures 
     – immunization rates increased 
     – preventive care visits increased 
     – emergency care visits and hospitalization rates decreased

 

 

Future Plans
 

In 2007 The Colorado Children’s Healthcare Access Program developed a demonstration program for 98 private practices to receive increased reimbursement is return for providing a medical home to Medicaid and CHP+ children. As of July 2008, that number has grown to 102 primary care practices and 350 providers throughout Colorado. CCHAP is in the process of expanding across Colorado to assess the barriers to care for Medicaid and CHP+ children in rural Colorado, and has set for itself to goal of creating a self-sustaining program by the year 2010.

 

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