COD E R E D

Table 2. Local Coverage InitiativesLocation Kansas City, MO Moore County, NC Wayne County, MI Muskegon, MI Alameda County, CA Alameda County, CALocal Coverage Initiative Chamber Choice First Plan HealthChoice Access Health Alliance Group Care Alliance Family CareOverviewOrganizational FormDelivery SystemStart Date 1994 2002 1994 1999 2000 2000 – 2004AdministratorPrivate, unsubsidized,small group coveragewith choice of open orclosed networkBlue Cross BlueShield of Kansas CityPrivate, partiallysubsidized, smallgroup coverage withchoice of open orclosed networkFirstHealth of theCarolinasPrivate, subsidized,small to medium sizedgroup coverage withchoice of open or closednetworkPatient CareManagement SystemPrivate, subsidized, smallto medium-sized groupcoverage with closednetworkAccess HealthPrivate, subsidized,workgroup specificcoverage with closednetworkAlameda Alliance forHealthPrivate, subsidized, familycoverage with closednetworkAlameda Alliance forHealthPublic/Private Private Private Private Private Private PrivateFeatures * RPR, BC, MC, RC RPR, MC, CM, QA PCA, SR, CM, QA RPR, CM, BC, MC, QA RPR, CM, QA IES, RPR, CM, QABasic Services Provided ** A – D A - E A - D A – D A - E A - GFirstHealth of theProvider(s) Private physicians Carolinas, privatephysiciansPrivate physicians Private physicians Local safety net Local safety netFinancialPatient Cost Share Yes Yes Yes Yes Yes YesFunding Sources Private, Cost Share Federal, Cost Share County, Cost ShareGrants, County, Federal,Cost SharePrivate, Grants, County,State, Federal, Cost SharePrivate, Grants, County,Cost ShareFunding Model Private insurance plan Private insurance plan Three way shared buy-in Three way shared buy-in Heavily Subsidized Heavily SubsidizedEligibility/EnrollmentChildren Yes Yes Yes Yes No YesAdults Yes Yes Yes Yes Yes YesIncome threshold 250% of FPL N/A N/A N/A N/A 300% of FPLBusinesses with up toOther50 employees80,000 (dependantsTotal enrollednot inc, 2004)Businesses with up to50 employees2,000 (2005)Businesses with at least3 employees19,019 (dependants notinc, 2000)Business with up to 50employeesIn-home supportiveservices workers1,150 (2004) 4,400 (2005) 7,400 (2004)% previously uninsured 40% 19% 100% 100% 100% 100%*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-37