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Gretchen McGinnis, Member of Colorado Access Executive Team, Named to State Innovation Model Workgroup

October 17, 2018

AURORA, Colo. — Colorado Access is pleased to announce that Gretchen McGinnis, senior vice president of health care systems and accountable care at the nonprofit health plan, was selected to be part of an important new committee. The State Innovation Model (SIM) Rural Health Innovation Global Budgets Workgroup is a 24-member workgroup, which started meeting in late August. The group is working to develop recommendations and identify key considerations for an all-payer global budget approach to health care payment in some rural areas of Colorado.

“In a rural area, there can be days when the hospital doesn’t have any emergency department visits and then days when there are five, but the emergency room needs to be open all the time,” McGinnis explained. “In the fee-for-service model, the hospitals only get paid for services provided — it’s a huge, unpredictable system for hospitals to keep services available and to provide the breadth of services the community needs with that unreliable funding.”

To address these problems, Colorado may pursue voluntary global budgets for hospitals in select rural areas. A global budget model promises a stable revenue stream for providers that is independent of patient volume and intended to allow providers the opportunity to transition to promising new models of care that would improve health outcomes, access to preventive services and service integration. Global budget models typically include expectations to maintain or improve the quality of care provided as well as reduce health care costs over time.

The workgroup is evaluating the feasibility of a proposed global budget solution and will submit a report to the governor’s office in December. The group includes community stakeholders from a variety of backgrounds, including representatives from the Department of Health Care Policy and Financing, the Division of Insurance, the governor’s office, the business community, three rural hospitals, and more.

“There are lots of different perspectives,” McGinnis said. “We’re far more effective when we can come together and wrestle with our own problems and come up with a solution that’s really authentic to Colorado.”

McGinnis serves as a representative from a Regional Accountable Entity (RAE), bringing a key perspective to the workgroup.

“As a RAE, Colorado Access is not necessarily going to be a true payer in this model but one of the reasons we were brought to the table is because we understand how these systems work together — how the rural hospitals need to connect tertiary care hospitals in populated areas and how access to specialty care is provided. As the RAE, we can be powerful in facilitating other solutions, like telemedicine and relationships between providers in the region. We’re a part of this committee because of our requirement and responsibility to look at health care as a whole in our region, and help guide the statewide transformation policy for this next administration and into the future.”

McGinnis’s participation in the workgroup is very much in line with the mission of Colorado Access: to partner with communities and empower people through access to quality, affordable care.

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About Colorado Access:

Founded in 1994, Colorado Access is a local, nonprofit health plan that serves members throughout Colorado. The company’s members receive health care under Child Health Plan Plus (CHP+), and Health First Colorado (Colorado’s Medicaid Program) behavioral and physical health, and long-term support programs. Colorado Access provides care coordination services and administers behavioral health and physical health benefits for two regions as part of the Regional Accountable Entity program through Health First Colorado. Colorado Access is the state’s largest single entry point agency, coordinating long-term service and supports for Health First Colorado recipients in five Denver metro area counties. To learn more about Colorado Access, visit coaccess.com.

 

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