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the county indigent care plan. Benefits extended to HCO enrollees included: case managementservices, more diagnostic tests, emergency room services, gynecological services,immunizations, prenatal care and well patient annual exams. Dental care and mental healthservices are not covered benefits. The provider network includes two federally qualified healthcenters, Thomason hospital outpatient clinics and some private physicians.EligibilityHCO enrollment no longer takes place at community health centers since it reached7,000 enrollees in 2004. Additional patients are only referred to HCO by Thomason Hospital’sER department. Eligible enrollees are adults over the age of 19 with incomes below 100% ofFPL, residents of El Paso County, and ineligible for other publicly supported programs.HCO enrollees select a primary care provider, nurse practitioner or primary care clinicfrom the EPFHN to serve as their medical home. Case management services are offered toenrollees with special health care needs.FinancingThrough its initial grant from the W.K. Kellogg Foundation, HCO was able to develop itsinfrastructure, staffing and daily office operations. At present, the program is administered bythe hospital district which assumes full responsibility of its financing. The Hospital District’sannual budget for primary care reimbursement is $850,000. Reimbursement rates to providersunder HCO equal Medicaid fee-for-service reimbursement rates plus 5 percent.Cost SharingFor HCO enrollees there is a $10 co-pay for physician office visits. The remaining costof care is subsidized by the hospital district.IIb. Models for Expanding CoverageChamber Choice xxv,11Kansas City, MOOverviewIn 1994, the Greater Kansas City Chamber of Commerce began marketing ChamberChoice for small and low-wage businesses in the area. Chamber Choice is a non-subsidized planthat offers a rate cap of two years to enrollees.Chamber Choice was a revised version of an existent small group plan already offeredby BCBS of Kansas City. Chamber Choice and BCBS of Kansas City’s existing small group planonly differed in that the small group plan at the time was not open to businesses with 50employees or less, did not offer any kind of rate stability, and was not marketed aggressively.However upon receiving the Chamber’s endorsement of Chamber Choice, BCBS of Kansas Citysimply expanded administration and staffing of its existent small group plan to Chamber Choice.11 Personal communications with Jeff Nelson, BCBS of Kansas City, November 2004D-16