1. A Presentation of the Colorado Health Institute 1576 Sherman Street, Suite 300 Denver, Colorado 80203-1728 www.coloradohealthinstitute.org Monitoring the health of Colorados safety net State Health Research and Policy Interest Group Meeting June 24, 2006 Jeff Bontrager, M.S.P.H.

2. 2 The Colorado safety net monitoring project Objectives: Build comprehensive database Assess the viability and sustainability of Colorados safety net Provide reliable and timely information on which sound policy decisions can be based

3. 3 Why did we decide to do this? Bipartisan support for shoring up safety net Identified the need for objective and independent information Patchwork of safety net providers Patchwork of legislative proposals

4. 4 Developing data-driven capabilities to support policymaking Source: Agency for Healthcare Research & Quality, April 2004. Articulating a common definition of the safety net Clarifying current concerns and priorities Understanding what questions need to be answered Who are the Stakeholders? Evaluating the impact of past and current initiatives Estimating short- and long-term effects of current options Recommending policy options Analyzing data Clarifying the limitations of current knowledge Disseminating findings Assembling a matrix of available data sources Determining available measures Identifying need for new or additional data Developing an inventory of current and past initiatives Definitions and Priorities What are the policy problems? What data are available to support policy decisions? Data What do the data indicate about the current state of affairs? Assessment What policy options are supported by the data? Action

5. 5 Our process and methods Convened project Advisory Committee Identified objectives and policy issues Ongoing: –Establishing our definitions –Identifying data gaps –Selecting data indicators –Incorporating qualitative and quantitative methods –Disseminating information

6. 6 Preliminary results: SN population In 2003-04: Colorado tied for 11 th highest uninsured rate in U.S. Colorados uninsured rate was around 17%, representing about 770,000 Coloradans Colorados uninsured rate has remained higher than national average (15.7%) Approximately 500,000 uninsured Coloradans had family incomes below 250% of FPL Source: Colorado Health Institute tabulations of Current Population Survey data 2003-04

7. 7 Preliminary results: Providers Structured interviews of independent clinics Assessment of resources available to provide services, capability to collect and use data Findings reveal significant data-related barriers Similar interviews with rural health clinics (ongoing)

8. 8 What have we learned so far? Three components of implementing safety net monitoring: 1.Defining the safety net 2.Identifying the policy issues 3.Communication and translation necessary for informing policy

9. 9 1. Defining the safety net Used existing safety net definitions as starting point Developed a provider-based definition, coupled with population characteristic

10. 10 2. Identifying the policy priorities Solicited feedback from advisory committee Synthesized feedback to identify the priorities Formed broad policy questions that will guide the project

11. 11 3. Translation & communication Obtaining feedback from policymakers Using a multi-faceted communications strategy Assessing the effects of policy changes

12. 12 What will success look like? Improved policy and program decision- making Measurable changes in access to care Full integration of the project into CHIs core functions

13. 13 Questions? Contact Jeff Bontrager: Bontragerj@ColoradoHealthInstitute.org

14. 14 BONUS SLIDE: Using maps to communicate effects of policy changes