By Joe Sammen

Many people — if not most — have already made up their minds as to whether health reform has been successful in Colorado and across the United States. Whether it’s the influence of news headlines or personal political views, there are a lot of opinions and strong feelings.

Joe Sammen

The truth is most of what we think we know about the effects of health reform is speculation. We may think costs will go down or up, or that access to health care services will improve or worsen, but those are all hypotheses, not proven facts.

Although some initial data do exist like enrollment numbers in new health insurance options and personal stories of navigating systems like Connect for Health Colorado, it’s far too early to tell if health reform will make as big an impact as people on both sides of the political spectrum say it will.

What we do know is that Colorado’s leaders have been working hard to implement local, state and national reforms for a long time. Even before the state’s important 2008 bipartisan Blue Ribbon Commission for Health Care, Colorado was working to improve its health care system. Recent legislation, such as the Hospital Provider Fee in 2009 and the Affordable Care Act in 2010, has given the state new tools in this work.

Communities across the state are also using innovative, collaborative approaches to improve access to the system, increase coverage and drive down health care costs. Eight Colorado communities were selected to implement projects that aim to deliver better care and decrease costs in Medicare, Medicaid and CHP+ through the highly competitive Health Care Innovation Challenge sponsored by the Centers for Medicare and Medicaid Innovation.

This and other work is driven by a hope that eventually we’ll have a more accessible, affordable and responsive health care system in Colorado. However, hard data on the early impacts of these health reform efforts are difficult to come by, and some may not be available for many months or years.

Quantitative data aren’t the only way to evaluate progress, though — qualitative data can tell us just as much or more.

Perhaps our best opportunity to understand the immediate impact of health reform is to ask communities to share their observations and experiences, and track changes in their stories over time. No one can better explain the real experience of health reform than the people affected by it.

A new project from the Colorado Coalition for the Medically Underserved, called Health is Local, is attempting to do just that. Through interviews with local health care leaders and conversations with local residents, Health is Local aims to put Colorado’s health reform work in the spotlight.

The four communities highlighted through Health is Local are the city of Colorado Springs, and the counties of Montrose, Summit and Yuma. These communities were chosen to represent the diversity of urban, Western Slope, mountain resort, and Eastern Plains areas of the state. Since October of last year, the Colorado Coalition for the Medically Underserved staff has been traveling across the state collecting stories of health reform.

In Colorado Springs, we were impressed by the sophisticated urban health care system that has been proactive in its approach to complex problems and changes. In this context, state and national reforms are welcomed as a new tool for driving positive change in the local health system. However, leaders feel that these reforms are no replacement for the community-driven innovations and locally-focused solutions already in motion.

In Yuma County, it was equally impressive to see how thoroughly residents have embraced their self-sufficiency as a community, wholly committed to supporting each other in times of need. The success of their homegrown approach rightfully makes some skeptical of a need for outside reform, but they are ready and well-positioned to quickly take advantage of any opportunities that align with local priorities.

The common theme we saw across all four communities, was that developing local solutions to local problems, designed with the unique needs of community members in mind, is the best approach to reform.

Over the next year, we plan to follow each of the highlighted communities as local and national reforms fully roll out. The impacts of reform will be documented over time at www.HealthIsLocal.org in an attempt to help leaders and policymakers measure progress and implement change. We hope you’ll follow along with us, and perhaps delay cementing your opinion on the success of health reform until this story has a few more chapters.
Joe Sammen is the director of community health initiatives at the Colorado Coalition for the Medically Underserved.