If you’re like me, you may be astounded that 2013 is coming to a close.  What a whirlwind of a year!  Each month this article has, in some way or another, emphasized that our industry is transforming at staggering rates.  I’ve stressed the significance of partnerships as the main imperative to successfully survive this transition and the Colorado Rural Health Center’s (CRHC) importance as your catalyst to collaboration.  Throughout this month’s editorial, please note the testimonials of our members and partners.

The Affordable Care Act (ACA) is upon us!  Time for speculation about what provisions will survive has passed, and scenario planning for the ACA’s implementation must now be our mission.  In 2013, our policy agenda focused on the highest priorities for rural healthcare providers and their patients, which all aligned with the forthcoming ACA implementation. 

Access to care aimed to support legislative action that would increase our rural residents’ abilities to acquire quality and affordable services at the appropriate time.  With Colorado’s Medicaid expansion, we hope our advocacy efforts will show fruitful results in allowing thousands new access to care.

Commercial coveragewas introduced into the marketplace with the intention of creating a capitalistic platform for payers to compete. Tied into access to care, our priority was to advocate for the rural voice and to promote options that would cover the most rural residents at the highest reimbursement rates for our members.

Accountable carewas a 2013 policy priority focused on securing resources for programs that would help providers meet new standards while maintaining a high level of quality care.  Various state legislations surrounded accountable care, and we were there in each discussion assuring that our policymakers understood the uniqueness of rural healthcare facilities.

Integration of carewas a conversation surrounding projects to increase the cohesiveness between physical and behavioral healthcare, which has been a problem exacerbated in rural areas of Colorado.  We feel this is an area where our advocacy helped make great strides as part of larger united voice among our partner organizations.

Workforcepriorities spotlighted incentives, such as loan repayment, and scope of practice.  We educated our state and federal legislators on the importance of loan repayment as a recruitment tool for underserved communities.  Additionally, we advocated for scope of practice policy that would increase the number of providers in rural areas, while also maintaining high quality of care.

Safety net paymentswere a common topic throughout the legislative session while we, and our partner organizations, took action against proposed policy that would reduce payments to these vital healthcare facilities.  We continue to strategically evaluate the intended and unintended consequences of healthcare payment reform through our policy and advocacy efforts.

You’ve told us that rural healthcare policy is your priority, and we will be putting forth our excellent degree of advocacy in 2014.  As over half of our members have renewed for 2014 and we’re welcoming many new healthcare facilities to our organization, we understand that you value having our voice unite yours.  Here’s a peak at what to expect in policy during the next year…

2014 will be an interesting year for healthcare in Colorado, but it is likely to have a softer presence in the legislature.  Given that implementation is in full swing, it’s not anticipated that there will be any major policy proposals in healthcare.  It is possible that funding and oversight for K-12 and higher education will take the center stage.  Additionally, it’s likely we’ll see some bills that address the social determinants of health such child care tax credits, child care assistance program and other anti-poverty proposals.    

The state’s financial position continues to improve as evidenced by the Governor’s policy proposal in November.  Funding is being restored to many programs, and the state reserves are being rebuilt after the wildfires and flooding.  For healthcare, the proposal included an increase in Medicaid provider rates, funding for the increased Medicaid caseload, new resources for programs that serve people with developmental disabilities, and funding for a new project called the Primary Care Specialty Collaborative.

Please be sure to enjoy the holidays, because next year we know you’re going to be busy!  We expect to hear a lot from you regarding our support with implementation of the ACA.  As always, I like to close this article by sincerely thanking our members and partners on behalf of myself and our staff.  It’s truly an honor being able to serve and advocate for Colorado’s rural healthcare.