COD E R E D

Table 1. Local Care InitiativesLocation El Paso, TX San Antonio, TX Denver, CO Detroit, MILocal Care Initiative Health Care Options CareLink Denver Health PlusCareStart Date 1999 1997 1994 1992OverviewOrganizational FormHealth CarePurchasing withManaged CareHealth CarePurchasing withManaged CareConsolidated SafetyNet Plan with ManagedCare Features andVertical IntegrationManaged Care PlanConsolidated No No Yes NoCoordinated No Yes Yes YesCollaborative Yes No No YesCommunity VoicesPatient CareBexar County Hospital Denver Health andAdministrative Authority Collaborative and FirstManagement SystemDistrictHospital AuthorityHealth NetworkDelivery SystemCoordinated Features *IES, PCA, SR,CMIES, IPRS, PCA, CM,QA, SRIES, IPRS, QA,CM, PHDLIES, PCA, QA, SRServices Provided ** A,C A - E A - F A-FUTSA Med School,CHCs, FQHC,All Public Safety Net FQHCs and other SafetyCommunity PartnersComm Medical Assoc,Hosp Dist, OtherProvidersNet ProvidersFQHCs,Patient Cost Share (y/n) Yes Yes Yes YesProvider PaymentEligibilityFFSFFS – Physicians% Charges, DRG- OtherVaries by ProgramCapitation PMPMChildren No Yes YesCounty, State, MedicaidMatchingAdults Yes Yes Yes $44 million (2004)Income Threshold 100% FPL 200% FPL Varies by program $250/month/personOtherResidents not eligiblefor other programsResidents not eligible forother programs$90 work expensededucted from incomeTotal Enrolled/Served 7,000 (2004) 53,000 (2004) 155,000 (2002) 25,000 (2004)*FeaturesIES Integrated Eligibility System(w/ local safety net)PCA Primary Care AssignmentRPR Reduced Provider ReimbursmentCM Case ManagementQA Quality AssuranceSR Structured Referral networkBC Broker CollaborationMC Marketing CampaignRC Rate Cap**Services ProvidedA Primary and Preventative CareB Inpatient careC Specialty CareD Pharmacy AccessE Behavioral Health CareF DentalG VisionD-35