Overview
The Colorado Healthcare Affordability and Sustainability Enterprise (CHASE) Board approved the creation of a workgroup at its October and November 2024 meetings. The workgroup was created in accordance with its bylaws to explore the establishment of a State Directed Payment (SDP) Program as well as reforms to the existing CHASE hospital provider fees and supplemental payments.
Through the CHASE program, hospitals pay a provider fee which is matched with federal Medicaid funds. These funds increase hospital reimbursement for care provided to Medicaid members and uninsured payments (above 99% of the upper payment limit and full funding of Disproportionate Share Hospital payments). Additionally, these funds improve quality of care through Hospital Quality Incentive Payments and the Hospital Transformation Program. They expand health coverage and access through expansions to Medicaid and Child Health Plan Plus (CHP+) coverage for children, pregnant people, low income adults, and working adults and children with disabilities.
When the hospital provider fee was first created in 2009, it was celebrated as a win-win-win by policy makers, the Department of Health Care Policy and Financing (HCPF), the Colorado Hospital Association (CHA), and community members because:
- Increasing hospital reimbursement rates reduces under-compensated care and the resulting cost shifting in the health care system
- Expanding eligibility for Medicaid and CHP+ provides coverage for thousands of uninsured Coloradans and reduces uncompensated care and its resulting cost shifting
- Receiving additional federal support for health care in Colorado without additional cost to the state’s General Fund budget
The success of the hospital provider fee is evident through an average increase of $450 million per year of net new funds to hospitals, as well as Medicaid and CHP+ coverage for more than 400,000 Coloradans, and an improvement in Medicaid’s hospital payment compared to cost ratio - that is a reduction in the need to shift costs to private payers - from 54 cents on the dollar to 79 cents on the dollar.
Health care affordability remains a top concern for communities across Colorado, and this project presents an opportunity to strengthen investment in Colorado Medicaid without expending additional state budget dollars.
Workgroup Objectives
The objectives of the workgroup are to develop comprehensive recommendations for revisions to CHASE including the addition of a SDP for CHASE Board consideration, such that HCPF can develop and advance a broadly supported proposal to submit to the federal Centers for Medicare and Medicaid Services (CMS) for implementation to begin no later than July 1, 2025.
Membership
The workgroup is comprised of the following members, appointed by the CHASE Board Chair in accordance with the Board’s bylaws:
- Josh Block, Deputy Chief Financial Officer, HCPF
- Nancy Dolson, Special Financing Division Director, HCPF
- Dr. Kimberley Jackson, CHASE Board Vice Chair
- Emily King, Senior Policy Advisor/Deputy Director of the Office of Saving People Money on Health Care, Governor's Office
- Annie Lee, President & CEO, Colorado Access
- Shauna Lorenz, Partner, Gjerset & Lorenz LLP
- Tom Rennell, Senior Vice President Financial Policy and Data Analytics, CHA
- Alison Sbrana, Consumer
Meeting Schedule
- June 18, 2025
This meeting will be held on June 18, 2025, from 12:00PM to 1:30PM, via Zoom.
- June 4, 2025
This meeting will be held on June 4, 2025, from 12:00PM to 1:30PM, via Zoom.
- May 21, 2025
This meeting will be held on May 21, 2025, from 12:00PM to 1:30PM, via Zoom.
- May 7, 2025
This meeting will be held on May 7, 2025, from 12:00PM to 1:30PM, via Zoom.
- April 23, 2025
This meeting will be held on April 23, 2025, from 12:00PM to 1:30PM, via Zoom.
- April 9, 2025
This meeting will be held on April 9, 2025, from 12:00PM to 1:30PM, via Zoom.
- March 26, 2025
This meeting will be held on March 26, 2025, from 12:00PM to 1:30PM, via Zoom.
- March 12, 2025
This meeting has been cancelled.
- February 26, 2025
This meeting will be held on February 26, 2025, from 12:00PM to 1:30PM, via Zoom.
- February 12, 2025
This meeting will be held on February 12, 2025, from 12:00PM to 1:30PM, via Zoom.
- January 29, 2025
This meeting will be held on January 29, 2025, from 12:00PM to 1:30PM, via Zoom.
- January 15, 2025
This meeting will be held on January 15, 2025, from 12:00PM to 1:30PM, via Zoom.
- December 16, 2024
This meeting will be held on December 16, 2024, from 9:00AM to 10:30AM, via Zoom.
- Resource Bank
- Approved State Directed Payment Preprints - Centers for Medicare & Medicaid Services (CMS)
- Colorado Hospital Association (CHA) Letter to HCPF
- Directed Payments in Medicaid Managed Care - Medicaid and CHIP Payment and Access Commission (MACPAC)
- Google Drive for Additional Resources
- Revised CHASE Workgroup Recommendation
- Workgroup Charter
- 2025 CHASE Annual Report