1. HEALTHCARE REFORM
JILLIAN JACOBELLIS PH.D., MS
COLORADO DEPARTMENT OF PUBLIC HEALTH AND THE ENVIRONMENT
MOVING CHRONIC DISEASE PREVENTION FORWARD IN AN ERA
OF REFORM

2. NATIONAL HEALTH REFORMS OPPORTUNITIES
FOR PUBLIC HEALTH

3. HEALTH REFORM

5. ACCOUNTABLE CARE ORGANIZATIONS

6. PREVENTION AND PUBLIC HEALTH FUND
(TITLE IV, SEC 4002)

7. CLINICAL AND PUBLIC HEALTH INTEGRATION

8. IMPLICATIONS FOR THE PUBLIC’S HEALTH

9. COMMUNITY TRANSFORMATION GRANTS

10. A YEAR OF THREATS
PREVENTION AND WELLNESS FUND

11. WHAT ABOUT COLORADO ‘S INSURANCE
COVERAGE?

12. COVERAGE AFTER IMPLEMENTATION OF THE
FEDERAL ACT IN COLORADO
800,000
258,000
175,000
153,000
214,000
Source: Colorado Health Institute, “Helping
communities prepare for health reform:
Coverage estimates of Coloradans after
implementation”

13. COLORADANS, AGE 0-64, BY INSURANCE STATUS
Medicare
1.4% Other private
insurance
Medicaid 9.2%
9.4%
Will be eligible for
federal subsidies
34.1%
Ineligible for
Uninsured subsidies*
17.5% 21.7%
Employer-sponsored Will gain eligibility
insurance (Medicaid/CHP+)
62.5% 30.4%
Currently EBNE
(Medicaid/CHP+)
13.7%
*Ineligible for subsidies includes
undocumented non-citizens,
documented non-citizens in the US
for less than 5 years, and citizens
Source: CHI analysis of the 2009 American Community Survey and non-citizens >400% of FPL

15. POST REFORM INSURANCE STATUS BY FPL
600,000
500,000 12%
18%
400,000
401% and greater
300,000 31% 251 to 400%
134 to 250%
9%
12% 0 to 133%
200,000
28%
100,000 39%
51%
-
Newly insured 543,000 Remaining uninsured 258,000
Source: Colorado Health Institute, “Helping communities prepare for
health reform: Coverage estimates of Coloradans after implementation”

16. RESULT = MORE PEOPLE INSURED

17. 1. Aspirin chemoprophylaxis
2. Childhood immunization series
3. Tobacco use screening and brief
intervention
PRIORITIES 4. Colorectal cancer screening
AMONG 5. Hypertension screening
EFFECTIVE 6. Influenza immunization
CLINICAL 7. Pneumococcal immunization
PREVENTIVE 8. Problem drinking screening and brief
counseling
SERVICES
9. Vision screening – adults
10. Cervical cancer screening
Maciosek MV, et al. Priorities among effective clinical services: results of a systematic review and analysis. Am J prev
Med 2006;31:52-61

19. CDC EXPECTATIONS OF STATES
Chronic Disease Prevention Programs:
•Leadership
•Surveillance and Epidemiology
•Communication and Media
•Policy and Environmental Change
•Engagement with health systems
•Provide TA to communities.
•Address multiple CDs and risk factors
simultaneously

20. CDC’ EXPECTATION OF STATES: FOUR FOCUS
AREAS

21. CDC WINNABLE BATTLES AREAS

23. EXPANDED ROLE FOR PUBLIC HEALTH IN
SCREENING PROGRAMS

25. BREAST CANCER DISPARITIES

30. IMPLICATIONS FOR SCREENING PROGRAMS

31. BUILD ON CANCER SCREENING
INFRASTRUCTURE AND HISTORY OF
COLLABORATION

32. WE ARE USING EVIDENCE-BASED
INTERVENTIONS

33. SCREENING PROGRAM COMPONENTS

34. POLICY IMPLICATIONS

35. DISCUSSION AND QUESTIONS