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Denver Well being

on Sep 5, 2015 in Eat Smart

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That’s as a result of since 2006, any Medicaid recipient with a Denver handle has been automatically enrolled within the Denver Well being Medicaid Alternative plan. This so-referred to as passive enrollment happens even if the affected person has been seeing one other doctor for years and lives nowhere near a clinic operated by Denver Well being. And it occurs although Denver Health has a ready listing that’s 1000’s of patients lengthy (although it’s taken significant steps to cut back it over the previous yr). Her husband had lately misplaced his job, and Presley’s income as a hairdresser wasn’t enough to pay for medical insurance.Denver Health

A number of issues can set off the passive enrollment, including if a Denver affected person would not expressly opt out of the Denver Well being plan when his or her Medicaid benefit comes up for annual renewal. It might also occur when a patient moves to a brand new Denver tackle or when a Medicaid baby is born in Denver, which is what happened most not too long ago to the Presleys. The paperwork instructed her to call if she wanted to decide Parker out of Denver Health’s plan, which she did.

Somewhat than being enrolled in Colorado’s regular Medicaid plan, which allows recipients to see any physician who accepts Medicaid, he was routinely enrolled in Denver Well being’s plan. Presley came house from the hospital to a pile of paperwork from Well being Colorado, the skin firm that the state pays to enroll Medicaid recipients within the various plans available to them. She additionally got paperwork informing her that Isabella could be switched to Denver Well being, as properly. So she known as Well being Colorado and informed them she did not need Isabella on Denver Well being’s plan, both.

Passive enrollment was established in 2006 as a solution to connect sufferers with a so-referred to as medical home. Because Denver Health serves as this medical house, the state pays the not-for-profit group a fee for every patient enrolled in its plan – whether or not a physician sees them or not. Again within the ’90s, when HMOs had been being hailed as the following great value-savers, state legislators handed a law requiring that 75 p.c of Colorado’s Medicaid patients be enrolled in a managed-care plan.

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