Q&A: Gretchen Flanders McGinnis, Senior Vice President, Colorado Access Healthcare Systems and Accountable Care – State of Reform

Gretchen Flanders McGinnis, MSPH – Senior Vice President, Healthcare Systems and Accountable Care

McGinnis joined Colorado Access in March 2000 and has played an integral role in the company’s growth since then. With over 17 years of healthcare experience, she has a unique understanding of healthcare systems and public policy.

McGinnis received his BS in Biology from Vassar College and his MS in Public Health from the University of Colorado, and is dedicated to working in the healthcare industry and serving underserved populations in Colorado. Before joining Colorado Access, she worked on health care policy issues at state legislatures across the country.

As Vice President of Colorado Access Healthcare Systems and Accountable Care, she currently oversees the company’s Accountable Care Partnership (ACC) contract, provider engagement, compliance and medical assistance sites, as well as legislative and external relations activities.

Reform status: As federal relief shifts from emergency to recovery, how will this affect Medicaid eligibility and enrollment in the state?

Gretchen McGinnis: “It is expected that the public health emergency will end this summer and those individuals who have not been required to re-establish their eligibility since the beginning of the pandemic and are no longer considered eligible will be removed. It is difficult to determine how many people will lose their Medicaid or CHP+ enrollment, But the total number of the two projects will definitely be smaller than it is now.

By early 2020, approximately 1.2 million members in the state were enrolled in Medicaid and CHP+. Those individuals who are ineligible will need to find other coverage, and may already have, either to transfer from Medicaid to CHP+, or to the Connect for Health exchange product. The number of uninsured people in the state is also expected to rise during this period. As the largest public health department program in the state, we are doing everything we can to be proactive with our members to ensure they understand what they need to do to maintain healthcare. “

Sol: What will investing in affordable healthcare look like during the recovery phase?

General Motors: “From a Medicaid perspective, because enrollment will decrease after the public health emergency is over, there will be less money available for investment. Now, effective use of ARPA funds is trying to build and support more access to care and services. Colorado Access is finding ways to support the changing health care delivery system through workforce support, alternative payment models and reducing health disparities.”

Sol: Access to behavioral health-related stigma disproportionately affects low-income and communities of color. Commissioner Dr Morgan Medlock said the BHA was focused on addressing the social determinants of health, namely economic policies within the larger social fabric to improve behavioural health outcomes. How will the relationship between the BHA, providers, payers and social support agencies ensure patient recovery in a lasting way?

General Motors: “This is really the key question. At this point, I don’t think we have enough information to really understand how the various systems will work together, but we do know that there is a deep commitment to collaboration between these different departments. Exactly how it works The nature still stands out.”

Sol: Does incentivizing providers through APM improve health outcomes in underserved communities? If this is the goal, what else can the delivery system do to improve the health of these communities?

General Motors: “It is unclear whether APMs will directly improve health outcomes, although they can and should be designed with health equity in mind. Ensuring reimbursement of providers in a way that supports the delivery of high-quality healthcare is necessary but not sufficient to provide improvements Outcomes. Patient active involvement in their health, access to other supportive health services (such as safe housing, access to quality food, etc.) all have a significant impact on outcomes. One thing delivery systems can do to support better outcomes is to identify and Find ways to pay for interventions that support health…”

This interview has been edited for clarity and length.

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