One Step at a Time: Summiting Mt. Medicaid
This blog was written by Aubrey Hill, Director of Health Systems Change for the Colorado Coalition for the Medically Underserved.
Summit Marker for Quandry Peak, Colorado
Last summer, I finally joined the ranks of "real" Coloradans because I summited my first "fourteener" at Quandary Peak ("fourteeners" in Colorado are peaks above 14,000 feet). Growing up below sea level in New Orleans, climbing a mountain that is 14,265 feet high is a pretty big achievement for me! I recall how I felt when I looked up at the mountain from the beginning of the trail. The altitude was already affecting my ability to breathe—even though I was in good shape—and the sheer height of the mountain was daunting. I was scared, but at the same time, I was determined—so I put my head down and placed one foot in front of the other. I am proud to say that several hours later, I bagged the summit.
At this time last year, I felt the same anxiety when we recognized that Colorado was about to expand Medicaid to potentially hundreds of thousands adults without dependent children (AwDC). We recognized that in order to do this successfully, we would need to coordinate many people across the state, hammer out many details, and make some important decisions—all in the face of uncertainty. We did not know what this expansion would ultimately look like (and it ended up being much smaller than we anticipated), but we knew we had to get started. My organization, the Colorado Coalition for the Medically Underserved (CCMU), began the Connect Campaign to coordinate the work on this issue, because we knew that working together was the only path to success. Sure enough, by placing one foot in front of the other, Colorado has moved ahead and launched the limited expansion in April of 2012.
The program has now reached its capacity of 10,000 adults, and we view this as a successful beginning, especially with the lessons that we learned and are able to apply moving forward. Examples of key lessons include: finding and reaching out to potentially eligible Medicaid patients through safety net providers that already have relationships with them, and encouraging strong case management on a clients' behalf so the process does not overwhelm them (this way clients are more likely to successfully complete their application and stay informed of their status). More examples of lessons and considerations for the future from the initial expansion are outlined in the report. (You can view the full report of our lessons learned, a 4-page executive summary, or a powerpoint presentation.)
We do recognize, though, that this initial limited expansion was hardly the end of the journey. In 2014, there are much larger changes coming, and it is important we use the time in 2013 wisely to ensure that we have a high-functioning Medicaid system that makes it easy for people to enroll in the coverage for which they qualify. The Connect Campaign is the perfect place to extend the conversation beyond AwDC to ensure an efficient and effective Medicaid overall.
We recently held a summit to discuss what we learned from the AwDC expansion and set the stage for the needed changes. At the summit, we all agreed that we needed to achieve a few things: clear messaging to reach out to eligible populations, working enrollment systems, and ready and accepting providers. It's a daunting task, but it seems that much more doable when so many people from different organizations are able to come together from across the state with a shared clarity of purpose and a willingness to move Colorado forward. One of my favorite quotes is, "What lies behind us and what lies before us are tiny matters compared to what lies within us." Colorado has shown that what lies within us is a passion for doing what's right for Coloradans who need health care, a drive to succeed no matter how difficult the task, and a willingness to work collectively to achieve our goals. The summit reminded me of Colorado's exceptional fortitude, and why our ultimate vision is achievable.
Using our passion, collective energies, creativity, and determination, we will certainly move forward this year towards a better Medicaid—a Medicaid that best meets the health care needs of the most vulnerable Coloradans before we reach the momentous date of January 1, 2014 when Colorado expands Medicaid to hundreds of thousands of low-income Coloradoans, as envisioned by the Affordable Care Act.