Access Monitoring Review Plan Presented by: Jessica Chislett, - - PowerPoint PPT Presentation

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Access Monitoring Review Plan Presented by: Jessica Chislett, - - PowerPoint PPT Presentation

Access Monitoring Review Plan Presented by: Jessica Chislett, Access Stakeholder Relations Specialist Jan-20 1 Our Mission Improving health care access and outcomes for the people we serve while demonstrating sound stewardship of financial


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Access Monitoring Review Plan

Presented by:

Jessica Chislett, Access Stakeholder Relations Specialist

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Jan-20

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Our Mission

Improving health care access and

  • utcomes for the people we serve

while demonstrating sound stewardship of financial

resources

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  • Health First Colorado members can access: the right

health services, at the right time, in the right setting, for the right duration.

  • The Department conducts ongoing and appropriate

access evaluation, develops evidence-based recommendations, and implements actionable solutions, in a timely and transparent manner.

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Our Vision

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Access Domains

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Ongoing Access Evaluation Alignment Across Programs and Activities Tracking, Evaluation & Reporting on Access Issues Rate Review Access Analysis and Committee Federal Regulatory Compliance

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What is the Department Doing to Evaluate Access to Care?

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  • Thoroughly and thoughtfully evaluate all questions and

feedback.

  • Identify what feedback can be incorporated now or

potentially in the future.

  • Transparently communicate the outcomes of feedback

and questions.

  • Refer individuals to appropriate Department resources

for out-of-scope topics.

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Our Engagement Commitments

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  • Methods for Assuring Access to Covered Medicaid

Services (80 FR 67575) ➢ Requires states to consider whether access to health care services will be impacted when provider fees are lowered or rebalanced (exceptions apply). ➢ Also requires states to draft an Access Monitoring Review Plan (AMRP) every three years to evaluate access broadly.

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Federal Access Requirements

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  • The AMRP reports on access to five broad categories
  • f services:

➢ primary care ➢ physician specialists ➢ Fee-for-service behavioral health ➢ pre- and post-natal obstetrics (including labor and delivery) ➢ home health services

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Access Monitoring Review Plan

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Utilizers

Primary Care

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Utilizers

Primary Care

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Primary Care

Providers

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Primary Care

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Primary Care

Providers

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Primary Care

Drive Time

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Specialty Care

Utilizers

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Specialty Care

Utilizers

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Specialty Care

Providers

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Access Monitoring Review Plan

Specialty Care

Drive Time

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Behavioral Health (FFS)

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Behavioral Health (FFS)

Utilizers

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Behavioral Health (FFS)

Providers

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Behavioral Health FFS

Providers

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Behavioral Health FFS

Drive Time

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Pre- and Post- Natal Obstetrics

Utilizers

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Pre- and Post- Natal Obstetrics

Utilizers

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Pre- and Post- Natal Obstetrics

Providers

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Pre- and Post-Natal Obstetrics

Drive Time

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Home Health

Utilizers

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Home Health

Utilizers

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Home Health

Providers

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Questions?

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Contact Details

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Jessica Chislett Access Stakeholder Relations Specialist jessica.chislett@state.co.us 303 866 2308

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Thank You!

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