An Interview with Catherine Strode
Gretchen Hammer is recognized as one of the state’s most respected leaders in healthcare. Formerly the State’s Director of Medicaid, she recently left the Colorado Department of Health Care Policy and Financing. For the past four years, Gretchen has overseen the Department’s Health Programs Office which administers the state’s public health insurance programs for low-income Coloradans including Medicaid and Child Health Plan Plus (CHP+). Prior to HCPF, she served as the Executive Director of the Colorado Coalition for the Medically Underserved (CCMU). As she looks back over the years of her tenure, Gretchen Hammer cites progress for the state’s Medicaid members in that they have reported satisfaction with the delivery and quality of their care.
What progress was made in the state’s Medicaid program during your tenure?
“One of the things we have seen is the Colorado Health Access Survey, the statewide survey done every two years, reflected that Medicaid members reported the health care system was meeting their needs at the same level as privately insured folks. To me, that is the foundational measure of progress for all of us who are healthcare leaders. We measure how well people think the entire health care system is meeting the needs of themselves and their family. I think we saw for the first time, an improvement among Medicaid members that the health care system was meeting their needs.”
How do you think Colorado can improve its Medicaid program?
“Medicaid is part of a larger health care system that sometimes doesn’t work very well. It’s hard to navigate. It’s confusing. It can be particularly hard for Medicaid members for a variety of reasons. They may have complex needs that require multiple people being involved in their care. and coordinating all of that care is really hard. There may be providers who don’t take Medicaid members into their practice. That is something we need to continue to work on. Also, we don’t have it figured out yet how to address components of people’s lives that impact their health like. food security or not having safe and stable housing. The evidence is very clear that those kinds of things impact people’s health. We are trying to be part of those community-based solutions. Medicaid has a role to play but we have to be embedded in other people’s activities to make sure those things get in place for people.”
What is underway to address social needs that impact health?
“In our new contracts for our Regional Accountable entities, we do have a responsibility and a recognition that you have to build partnerships to help people get connected. We have tried internally. For example, for the Women, Infants and Children (WIC) program, we have aligned WIC participation with Medicaid enrollment. If you are enrolled in Medicaid and you qualify for supplemental nutrition when you’re pregnant or breast feeding, we make sure you get connected to those services. Through our PEAK (Program Eligibility Application Kit) application, we have tried to make sure if someone has needs in multiple parts of their lives, that they get connected to those. We are changing the way we create access to the tobacco cessation benefits through the Medicaid program. We’re trying to do everything we can to reduce Medicaid barriers to getting those supports. Those are the things we can do at the state level. There is still more work to be done in that area. Some of that work has to happen at the community level.”
What challenges face your successor in managing the state’s Medicaid program?
“We are in many ways a health coverage program. We are purchasing and paying for the same services that private insurance and Medicare are paying for: services delivered in hospitals and doctors’ offices. We need to continue the conversation about how we can get better value out of the health care dollars we’re spending, both in the Medicaid program and overall. We know in Colorado in particular, health care is unaffordable for many privately insured people. Some of the products that are available in the market create high deductibles. Your mortgage can be less than your private health insurance premium. I think there’s an important frame to figure out what we can we do through our public systems and our private systems to try and bring that cost down and make care more accessible in easier places.”
What are your hopes for the state’s Medicaid program going forward?
“Medicaid plays a critical role in investing in our citizens. Medicaid pays for 42 per cent of the births in Colorado. There are 178,000 children under the age of five who are served by the Colorado Medicaid program. Our opportunity to set women, children and families off on the right foot is remarkable. We have the opportunity to make sure if a mom is suffering from a pregnancy-related depression, or a child has a developmental delay, Medicaid can be the place where those issues can be identified and managed. Similarly, in our volatile economy, have fewer people staying in jobs for decades at a time. Individuals have relied on Medicaid as they go through a career change. It is a critical way in which we support individuals to have adequate health insurance coverage that helps protect their financial well-being. It creates access to services so people can get screenings and good primary preventive care. My hope is we still continue to see Medicaid as that critical societal investment that we make in our communities.” Our mission statement is access to care and health outcomes and being a good steward over our public resources. I think those two things can and do operate together.”
Catherine Strode is Advocacy Denver’s Communications and Policy Specialist. She holds a Masters degree in Public Administration with an emphasis in Health Care Policy. Catherine publishes Policy Perspective, featuring interviews with state policy makers on issues that affect the work and mission of Advocacy Denver.