McGinnis joined Colorado Access in March 2000 and has played an integral part in the growth of the company since that time. She has more than 17 years of health care experience, and brings a unique understanding of health care systems and public policy.
McGinnis received a Bachelor of Science degree in biology from Vassar College and earned a Master of Science degree in public health from the University of Colorado, and has devoted her career to working in the health care industry and serving the underserved in Colorado. Prior to joining Colorado Access, she worked on health care policy issues at the National Conference of State Legislatures.
As Vice President of Healthcare Systems and Accountable Care at Colorado Access, she currently oversees the company’s Accountable Care Collaborative (ACC) contracts, provider engagement, compliance and medical assistance sites, as well as legislative and external relations activities.
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State of Reform: With federal relief shifting from emergency to recovery, how will this affect Medicaid eligibility and enrollment in the state?
Gretchen McGinnis: “The anticipated end of the public health emergency this summer will remove those individuals who have not had to re-establish their eligibility since the start of the pandemic and are no longer deemed eligible. It’s difficult to know for sure how many people will lose Medicaid or CHP+ enrollment but the total number of individuals on both programs will certainly be less than it is now.
The state had around 1.2 million members on Medicaid and CHP+ in early 2020. Those individuals who lose eligibility will need to find other coverage and perhaps already have, either moving from Medicaid to CHP+ or moving to the Connect for Health exchange products. It is anticipated that the number of uninsured in the state will increase during this time as well. As the largest public health sector plan in the state, we’re doing everything we can to be proactive with our membership to make sure they understand what they need to do to maintain health care.”
SOR: What will the investment into affordable care look like in the recovery phase?
GM: “From the Medicaid perspective, since enrollment will decrease after the public health emergency is over, the amount of dollars available to invest will be smaller. Effective use of the ARPA funds now is attempting to build and support enhanced access to care and services. Colorado Access is looking at ways to support the changing health care delivery system through workforce supports, alternative payment models, and reducing health disparities.”
SOR: Access to and stigmas surrounding behavioral health have disproportionate impacts on low-income and communities of color. Commissioner Dr. Morgan Medlock says the BHA is focused on addressing the social determinants of health, namely the economic policies in the larger structure of society, to improve behavioral health outcomes. What will the relationship between the BHA, providers, payers, and social support agencies look like to ensure patients recover in a way that is lasting?
GM: “That really is the critical question. At this point, I don’t think we have enough information to really understand how the various systems will work together but we know there is a deep commitment to collaboration among these various departments. The exact nature of how that works is still outstanding.”
SOR: Will incentivizing providers through APMs lead to improved health outcomes in underserved communities? What more can the delivery system do to improve the health of these communities if that is the goal?
GM: “It is not clear whether APMs will lead directly to improved health outcomes, although they can and should be designed with health equity as a goal. Ensuring providers are reimbursed in a way that supports the provision of high quality health care is necessary but not sufficient to deliver improved outcomes. Active participation of the patient in their health, access to other supportive health services such as safe housing, access to high quality food, etc., all have a significant impact on outcomes. One thing the delivery system can do to support better outcomes is to recognize and find ways to pay for interventions that support health …”
This interview was edited for clarity and length.