Report to the Community

Report to the Community

Fiscal Year 2021-2022

The Department administers Health First Colorado (Colorado’s Medicaid program), Child Health Plan Plus (CHP+), and other public health care programs for Coloradans who qualify.

Our mission is to improve health care equity, access and outcomes for the people we serve while saving Coloradans money on health care and driving value for Colorado.

Who we serve

Percentage of Total Population Enrolled in Health First Colorado and Child Health Plan Plus, by County

Colorado map of Health First Colorado and Child Health Plan Plus members by county, combined. 13 counties with 0-19% enrollment, 31 counties with 20-34%, 17 with 35-49% and 3 counties with 50% or more.
Source of enrollment data is Medicaid Management Information System (MMIS). Percentages represent people enrolled for one day or more during calendar year 2021. 2021 population data as forecasted by the state demographer.

How we deliver care

Health First Colorado logo1.6 M

Health First Colorado
Colorado's Medicaid program

A public health care program that provides access to physical & behavioral health care, hospitalization, nursing facility care, prescription drugs, dental care & other benefits.

Baby icon53,000

Child Health Plan Plus (CHP+)
CHP+ provides comprehensive health care benefits, including dental care, to uninsured children ages <18 and pregnant people who do not qualify for Health First Colorado
and cannot afford private health insurance.

Icon of a hand and a person35,000

Colorado Indigent Care Program
CICP allows Coloradans with incomes up to 250% of the Federal Poverty Level to receive discounted health care services at participating hospitals, community health centers and clinics.

Tooth icon


Dental Programs
Health First Colorado offers dental benefits to children and adults. The adult dental program completed its sixth year of services on June 30, 2021.

Clipboard icon


Buy-In Programs
The Health First Colorado Buy-In programs allow members with disabilities to pay a premium for Health First Colorado if they earn too much to qualify, so they don’t have to choose between work and health coverage. Learn more about Buy-In programs for adults and children.

Medical provider icon62,510

Long-Term Services & Supports (LTSS)
LTSS provides comprehensive care for members 65 and older and people with disabilities, so they can:

House iconLive in a setting they choose with the supports they need

Icon of three peopleParticipate in communities that value their contributions

Icon of a hospitalAccess services in a simple, timely & streamlined manner

A blue medical cross and a checkmarkGet the highest quality services

Accountable Care Collaborative

The Accountable Care Collaborative (ACC) is at the core of Health First Colorado. Launched in 2011, it creates Regional Accountable Entities (RAEs) that deliver the programs that will improve member health and reduce costs across the state. Learn more about the ACC.


Members Served by Waivers

Tree map showing breakdown of members on waivers with the largest quantity at 31,632 on EBD, 8,100 DD, 5,447 SLS, 4,323 CMHS, 2739 CES, 2,450 CHCBS and 725 BI.
Elderly, Blind, and Disabled (EBD), Developmental Disabilities (DD), Supported Living Services (SLS), Community Mental Health Services (CMHS), Children’s Extensive Support (CES), Children’s Home & Community-Based Services (CHCBS), Brain Injury (BI), Children’s Habilitation Residential Program (CHRP), Complementary and Integrative Health (CHI, formerly known as the Spinal Cord Injury (SCI) waiver), Children With Life Limiting Illness (CLLI)

Who is covered and what does it cost?

In Fiscal Year 2021-22, the Department Paid: $10.3 billion in services for 1.6 million people Numbers are approximate. Health First Colorado and Child Health Plan Plus expenditures only.

Two stacked bar charts comparing member populations with the expenditures by the same population, the highest being expansion adults at 36% population and 26% expenditure and children & adolescents at 39% and 19%. The lowest is members with partial Medicaid benefits at 3% and 2% and the highest contrast is people with disabilities at 6% and 30%.

Patient Protection and Affordable Care Act (ACA) Medicaid Expansion. Due to rounding, percentages may not total 100%. *The majority of funding for Expansion Adults is federal dollars, with the state fund source funded by the Healthcare Affordability and Sustainability Fee.
**Not all members with disabilities use long-term services and supports.

Department Expenditures by Fund


Tree map of expenditures with federal funds & reappropriated funds at 65.3%, general fund 23.3%, Healthcare Affordability & Sustainability Provider Fee 7.9% and cash funds 3.5% with total funds at $12.8 billion.

*Includes all services and administrative line items, including Colorado Indigent Care Program and Old Age Pension.

Payment Breakdown to Health First Colorado Partners

Horizontal bar charts showing payment breakdown in percentage and dollars to Health First Colorado Partners with the largest to hospitals, home and community-based services, pharmacy & physician administered drugs, behavior health capitation and professional services from $3.08 to $1.03 billion and 25.6% to 8.6% respectively. The remaining payments are in millions with the lowest at $46 million and .04% for intermediate care facilities.

This chart refers to medical services cost only, not total Department spending. It is based on claims data by date of service and will differ from data calculated on a cash accounting basis. Due to rounding, percentages may not total 100%.

What we accomplished in FY 21-22

To support our mission, we focused on several priority areas:

Transforming home & community-based care
We received state and federal approval to leverage $530 million of American Rescue Plan Act (ARPA) federal stimulus to implement lasting transformation for people with disabilities and long-term care needs. Our initiatives enhance, expand and strengthen home and community-based services (HCBS) in Colorado through the end of 2024. There are currently 63 projects in progress to support recipients of long-term services and supports (LTSS), their families, providers and the health care workforce. Our most recent quarterly reports are available on our website.
Transforming behavioral health
Thanks to General Assembly support of transformative legislation, the Department is partnering with the new Behavioral Health Administration to expand behavioral health services for our members. This includes adding residential beds, expanding the provider network, improving transparency and reporting, and catalyzing care coordination. To support this work, the Department has increased our investment in behavioral health by $400 million since FY 2018-19, now totaling over $1 billion annually, and has expanded the provider network to include 10,300 active behavioral health providers, including 1,000 added from September 2021 through August 2022.
Expanding the health care workforce
The Department is part of a multi-agency state effort, with providers, advocates, members, families and workers, to expand and support the health care workforce. The General Assembly approved Health First Colorado rate increases for providers and certain health care workers, including a $15/hr minimum for direct care workers and those working in nursing facilities. The Department is investing in telemedicine, expanding data infrastructure, supporting the existing workforce, partnering on training, recruitment, and career pathway creation and helping identify geographic differences in the health care workforce.
Leading on affordability
The Department is working to save people money on health care, focused on the top two drivers of health care costs: prescription drugs and hospital prices. To bring down prescription drug costs, the Department has made progress on value-based contracts and payments, drug importation where federally permitted, and the Prescriber Tool, driving to implement the affordability recommendations in our report: Reducing Prescription Drug Costs in Colorado. To make hospital services more affordable, the Department is partnering with hospitals to recognize where we are outliers in the nation, asking hospitals to make meaningful pricing changes. As part of that effort, the Department published nationally leading hospital price, cost and profit transparency reporting. Value-based payments are being implemented across the spectrum of care — hospital care, primary care, maternity care, behavioral health, prescription drugs and more — to reward quality outcomes and affordability.
Committing to health equity
We updated our mission in 2021 to highlight our commitment to “improve health care equity, access and outcomes for the people we serve while saving Coloradans money on health care and driving value for Colorado.” While the Department is working hard to apply a health equity lens across all our programs and initiatives, we have identified four initial health disparity areas of focus within Health First Colorado, including: vaccination rates, maternal care, behavioral health and prevention. Read more about this in our first Health Equity Plan.
Ensuring continuous coverage
At the beginning of the COVID-19 pandemic, the federal government declared a public health emergency (PHE) which required states to continue Health First Colorado coverage, even if someone becomes ineligible, among other things. Health First Colorado and CHP+ grew by more than 440,000 members (35%) and now serve 1.69 million Coloradans. That’s 1 in 4 Coloradans. As a result, together, we kept the uninsured rate steady at about 6.6% through the pandemic. With the economy rebounding and the federal PHE expected to end, the Department has a 14-month plan to make sure that people who are eligible stay covered and those who aren’t can find reduced cost coverage on the Connect for Health Colorado marketplace.
Improving member & provider experience
The members who participate in our programs are at the center of everything we do. We track several metrics to ensure we’re improving their experience and collect real-time feedback from our Member Experience Advisory Council. In the past year, our Member Call Center answered calls in less than 30 seconds on average. Eligibility system innovations and automation have driven our automatic approval rate to approximately 34% for all members renewing. This means there is no member or eligibility worker activity needed for these approvals. These system innovations have also enabled us to process 97% of applications within 45 days. For our providers, claims were processed in less than four days and calls were answered in well under one minute on average through the last half of the year. Together, we have handled the 35% membership growth without any major operational issues and expanded the Health First Colorado provider network by 28% over the past few years, with 96,800 providers now enrolled.


Download this report in PDF format.

A message from the Executive Director

I am extremely proud of our accomplishments together over the past fiscal year (July 2021-June 2022), which is reflected in this annual report. Thank you for your partnership in another unprecedented year for health care. Together, we successfully served an additional 440,000 Coloradans in need — an increase of 35% — since the start of the pandemic.

We are covering 1.69 million, or one in four, Coloradans — including more than 40% of Colorado’s children and more than 40% of births in the state.
This support during the pandemic has been a lifeline for Coloradans. Our safety net programs have helped keep Coloradans covered through the COVID-19-induced economic downturn, maintaining a steady 6.6% uninsured rate. This annual report shows how we not only grew our provider network to meet the needs of members, but also how we invested in health care delivery to improve care quality, service, equity and affordability. We appreciate our partners who worked with us through this pandemic. For more detailed information on what we accomplished together, please see our Performance Plan.

Looking ahead, there is still much work to do to help Coloradans thrive. We’re focusing our efforts on several key areas in the coming months.

  • Continuity of coverage after the end of the COVID-19 public health emergency (PHE). Once the PHE ends, each member of Health First Colorado and Child Health Plan Plus (CHP+) will need to return to the annual renewal process. Our revamped renewal process will smooth the process for members. Thanks to HB 22-1289, we also waived the CHP+ enrollment fee so children who qualify for CHP+ can auto-enroll if they no longer qualify for Health First Colorado. We are also working closely with Connect for Health Colorado to improve Coloradans’ awareness of coverage programs and the financial assistance available for those who no longer qualify for our programs.
  • Driving affordability and quality care. Amidst the unprecedented growth in membership, we kept Health First Colorado cost trends flat while evolving innovations that improve quality, reduce disparities and improve the health of our members. Our leadership in prescription drug and hospital affordability will continue to help us manage our own budget (about 1/3 of the state’s overall budget), while helping save Coloradans and employers money on health care as well.
  • To further impact affordability transformation, we continue to prioritize value-based payments in primary care, maternity care, prescription drugs, behavioral health, and hospital care that reward improved access to quality care, health equity and affordability. Value-based payments reduce disparities and are a benchmark of our Health Equity Plan. We also ensured that health equity plans are now part of each Regional Accountable Entity (RAE) and Managed Care Entity (MCE) contract. This important lever is foundational in achieving better health and reduced health care disparities. Advances in member care coordination and support, cost and quality indicators, the Prescriber Tool and other innovations will further improve care access, quality outcomes and overall affordability.
  • Life changing opportunities. Current economic conditions are difficult. It’s pivotal that we offer a range of solutions to help people rise and thrive in Colorado. We’re partnering with other state agencies to promote several unique funding opportunities that can help our members thrive. Among the most significant are the Colorado Cash Back Refund, Child Tax Credit and Earned Income Tax Credit and free health care workforce training through Care Forward Colorado. These programs offer life-changing opportunities to help lift up Coloradans.

Thank you again for your ongoing partnership in transforming health care for the betterment of our members and all Coloradans. I hope you enjoy this annual report.

Kim Bimestefer signature
Kim Bimestefer
Kim Bimestefer, Executive Director, HCPF