A Message from the Executive Director

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Kim Bimestefer
Kim Bimestefer

July 2022
A Look Back and Thank You Before We Look Forward Together  

Thank you for your partnership in another unprecedented year for health care. Together, we successfully served an additional 375,000 Coloradans in need – an increase of 30% - since the start of the pandemic. We are covering 1.62 million Coloradans, or one in four as we begin this new fiscal year. Clearly, our safety net programs have helped keep Coloradans covered through the economic downturn, with an uninsured rate steady at around 6.6%. 

Your support in improving care access to meet the needs of so many more members during a pandemic has been critical. Together, we expanded our provider network by 28% over the past few years, with 95,000 providers now enrolled in Health First Colorado. That includes more than 10,000 active behavioral health providers. A very special thank you to the General Assembly and the Joint Budget Committee for their 2% across the board provider reimbursement rate increase effective July 1, for the specific rate increases propelled through our Medicaid Provider Rate Review Advisory Committee (MPRRAC) process, and for the wage increases for certain direct care and nursing home workers – all critical to supporting our providers in their quest to take good care of our members, reduce disparities, improve quality and increase provider access overall.  

Together, we also successfully directed American Rescue Plan Act (ARPA) funding towards a number of meaningful, impactful, transformational projects to the betterment of our providers and those we serve, such as: strengthening the behavioral health safety net, stabilizing behavioral health crisis services, improving behavioral health access and integrating behavioral health into primary care; improving the affordability and accessibility of rural care; addressing health disparities with a focus on COVID-19 vaccination rates; targeting services to high-risk populations, especially individuals with disabilities and our older adult members; and investing in the health care workforce. 

We also continued to improve the customer experience – for members and providers. Our Member Call Center answered calls in less than 30 seconds on average, all year. Special thanks to our counties and medical assistance sites for your partnership and collaboration. Our investments in 50+ CBMS system enhancements and other modernizations are paying off. The initial eligibility and renewal processes are more member-focused and automated, with 97% of applications approved within 45 days and projected reductions in error rates and rework.  Missing information in eligibility correspondence is down to 0.012%, which is a massive improvement. And now, members can view coverage status and update information real-time online through PEAK, our online portal. For our providers, claims are processed in less than four days and provider calls are answered in an average of less than one minute. Together, we have handled the 30% membership growth without any major operational issues, which is an accomplishment we should celebrate together. 

Amidst this growth, we kept Health First Colorado cost trends flat while evolving innovations that improve quality, reduce disparities and improve the health of our members as well. Our health care affordability leadership in value-based payments, prescription drug and hospital cost control will continue to help us manage our own budget (1/3 of the state’s overall budget), while helping save Coloradans and employers money on health care as well.  

Thank you for your partnership on these important endeavors. Please feel free to view our performance on Administration goals at dashboard.colorado.gov. Finally, please join our July 19 webinar to celebrate what we accomplished together, review priorities for next fiscal year, and give us your feedback. 

June 2022

June 2022
Historic Legislative Session for Health Policy

Thank you for your partnership in a historic legislative session for health policy. Together, we are making transformative investments in behavioral health, workforce, pandemic management, affordability and coverage. While the Department is tracking and implementing more than 50 bills passed this session, here are some of the highlights: 

Behavioral Health. 20 bills touched behavioral health and substance use, many memorializing Behavioral Health Transformational Task Force recommendations including the investment of $450 million in American Rescue Plan Act (ARPA) dollars. HB 22-1278 creates the Behavioral Health Administration, a landmark achievement that will help coordinate the efforts across state agencies to transform the behavioral health system, achieve shared goals and pursue a shared vision that puts Coloradans first.  

Supporting Workforce, Older Adults & Pandemic Management. Several bills will help Colorado move from pandemic responsiveness to endemic management and pandemic readiness. They include measures focused on vaccinating, testing and treating through hospital system owned primary care providers as well as hospital staffing improvements (HB 22-1401); targeted funding to support nursing homes (HB 22-1247); and higher base wages for nursing home workers (HB 22-1333) as well as home and community-based direct care workers (HB22-1188). Also, the Department is thrilled at the passage of SB 22-203, which creates a more efficient, effective and transparent oversight structure for Program of All-Inclusive Care for the Elderly (PACE) - an all-inclusive benefit for older adults who need long-term services and supports. 

Affordability. As stated by Gov. Polis, this was a landmark legislative session for saving people money on health care. HB 22-1285 increases hospital price transparency, predicted to drive down outlier prices impacting communities. Additionally, HB 22-1370 will pass along drug manufacturer rebates to employers and consumers – valued at more than 16% of overall drug costs for those not sharing in rebates now. This bill represented one of the policy recommendations in the Department’s 2021 Reducing Prescription Drug Costs in Colorado Report. Also, SB 22-200 provides funding for rural hospitals to invest in affordability solutions that help reduce rural hospital and clinic prices. Finally, the long bill supported the Department’s expansion of value-based payment models, designed to improve quality, reduce disparities and drive affordability across primary care, maternity care, prescription drugs and specialty care. 

Coverage. Significant progress was made on expanding health coverage. Thanks to HB 22-1289, more children and pregnant people will be eligible for health coverage through a new program the Department will administer to reduce the uninsured rate. This bill also enables HCPF to move eligible individuals from Health First Colorado (Colorado’s Medicaid program) to Child Health Plan Plus (CHP+) at the end of the public health emergency without member action by eliminating the annual CHP+ enrollment fee. SB 22-081 also passed, supporting coverage transitions and improving awareness of financial assistance that makes coverage more affordable to help keep Coloradans covered. 

Thank you for your collaboration on advancing such important policies. We appreciate the hard work, passion and expertise of our elected officials, advocates, providers and stakeholders. For more information, please visit our Legislator Resource Center

May 2022

May 2022
May is Mental Health Awareness Month

This month presents an opportunity to underscore the importance of our comprehensive, collaborative work to develop an equitable, accountable and effective behavioral health system that improves the health and well-being of Coloradans. It also serves as an opportunity to celebrate all the amazing work in process to achieve this shared goal. Consider this:  

Investment. First, we want to thank the Polis-Primavera Administration and the legislature for continued investments in Medicaid’s behavioral health budget, with a funding increase of over $400 million since 2018, and a behavioral health budget over $1 billion for the 2022-23 fiscal year. We also invite you to celebrate the $450 million in American Rescue Plan Act funding approved by the Polis-Primavera Administration and the legislature, generated from the Behavioral Health Transformation Task Force Recommendations report and designed to transform the behavioral health system to the betterment of all Coloradans.  

Legislation. These transformational investments are memorialized in a host of bills moving through the legislature this 2022 session. These bills establish the Behavioral Health Administration (BHA) HB22-1278, improve access and quality outcomes, invest in local behavioral health programs, enhance physical and behavioral health integration with Department grants HB22-1302, invest in the establishment of universal contracts, create transparency into pay disparities and opportunities to close those disparities HB22-1268, redefine the safety net, improve care for historically marginalized communities and more.  

Community Mental Health Center (CMHC) and Safety Net Accountability and Efficiency. The Department is also working to increase behavioral health provider accountability and relationship modernization in four areas: (1) new cost reporting templates, protocols and technical assistance will be released this month and will be used to calculate reimbursement rates for CMHCs effective July 1, 2023, expanding to all safety net providers the next year; (2) a universal contract will define obligations of safety net providers in meeting the needs of their communities while also holding payers like Medicaid and the BHA more accountable to behavioral health providers; (3) value based payments will align with universal contracts and will create and reward shared patient outcome and health equity goals; and (4) providers will identify opportunities to reduce administrative burden for discussion with HCPF, CDHS and the BHA.  

Health Equity. HCPF’s Health Disparities, Equity, Diversity & Inclusion Officer testified on May 2 about the importance of statewide mental health equity efforts.  

Thank you for your collaborative efforts to revitalize, strengthen and transform our behavioral health system and increase accountability across all aspects of the industry. We appreciate your partnership and your passionate engagement.

April 2022

April 2022
Partnerships Past the Pandemic

At our recent Health Cabinet Policy Summit, 91% said it’s critical for all of us to work together through the end of the public health emergency (PHE). We estimate that more than 560,000 Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus (CHP+) members in the continuous coverage category will be reviewed for benefits when the nation transitions out of the PHE.  

In crafting our end-of-the-PHE plan, our goals include: continuity of coverage for our members no longer eligible for Health First Colorado/CHP+; implementing operational changes to improve the member experience; and minimizing the impact on county and medical assistance site eligibility workers wherever possible. To address the second and third goals, we have automated aspects of member renewals. We want to thank our county partners, sister agencies, Connect for Health Colorado and community organizations for collaborating to achieve these goals. Fortunately, the federal government is allowing up to 14 months after the end of the PHE for member coverage renewals and transitions. We invite you to register for our Apr. 15 webinar at Colorado.gov/hcpf/phe-planning to learn more about our plan and how you can help.  

While we don’t know exactly when the federal government will end the PHE, there are steps we can take now to be ready. One of the most important is for member addresses to be accurate so they receive important coverage and renewal information. To make updates, members can: 

  • Visit Colorado.gov/PEAK 
  • Use the Health First Colorado app on their phone (free for Health First Colorado and CHP+ members) 
  • CHP+ members can call 800-359-1991 while Health First Colorado members can call their county department of human/social services. 

Planning for the end of the PHE and coverage continuity was just one topic at our recent Health Cabinet Policy Summit. Other topics included health care affordability, behavioral health transformation, policy considerations from our Hospital Insights Report, and pandemic to endemic management of COVID-19. Our audience of ~1,000 attendees also shared:  

  • 78% said that if another booster in the series is recommended by the CDC for their age group, they would definitely or likely want it  
  • 80% are very concerned about affordability or it’s their top concern. 53% are most concerned about hospital costs followed by prescription drug costs (46%) 
  • 37% said price reductions is their top priority for how hospitals spend down excess reserves; 35% said workforce expansion/wage increases; 24% voted for community investment 
  • 50% said behavioral health is their top priority for hospital community benefit investments; 27% said health disparities; 16% said housing & supports for persons experiencing homelessness 

You can view summit materials on our Affordability website

Thank you again for your tremendous partnership to address the unprecedented challenges faced over the last two years. Thanks to your outstanding efforts and leadership, we have weathered this incredibly difficult period far better than many other states. As we prepare for the shift from pandemic responsiveness to endemic management and pandemic readiness, continued collaboration remains critical to achieving our shared goals to move Colorado forward in a way that improves health care equity, access, outcomes and affordability. 

March 2022

March 2022
Right Care, Right Place, Right Time, Right Price

Thank you for your continued partnership to help ensure the 1 in 4 Coloradans we serve receive the care they need - that it is readily accessible, high-quality, equitable and affordable. We appreciate your partnership in achieving this vision. Thank you to the more than 90,000 providers across the state who share a passion to serve Health First Colorado (Colorado’s Medicaid program) members. And thank you to the 17,165 providers, 30 pharmacies and 887 pharmacists who joined our network in the 18 months leading up to Dec. 31, 2021.

This month, the Lt. Gov. and state agency leaders are discussing several timely policy priorities at our virtual Health Cabinet Policy Summit Mar. 24 and 31, from 3-4:50pm. Topics include affordability, behavioral health transformation, pandemic to endemic & future readiness, and keeping Coloradans covered after the Public Health Emergency. At the summit, you’ll also hear more about our work to improve quality care and health equity for our members. As part of that, we are expanding our value-based payment models that reward providers for better patient outcomes, closing health disparities and driving affordability. This work spans the Hospital Transformation Program, maternity bundled payments, the Prescriber Tool, primary care and an exciting partnership to design the emerging Providers of Distinction program. At the summit, the Department will also release and review a Hospital Insights Report that synthesizes emerging hospital financial insights with key findings from several recent legislative reports while providing related policy considerations to address opportunities - register now.

March is developmental disabilities awareness month. We invite you to join Department staff and leadership in celebrating the tremendous strides made in the last 35 years for those living with intellectual and developmental disabilities, particularly the improvements in access to important services that help people live a life that is meaningful and fulfilling to them. But we still have more work to do. The Department remains dedicated to partnering with members, their families, providers and the advocacy community to make A Colorado for All while advancing community services for Health First Colorado members living with intellectual and developmental disabilities. 

Thank you again for all that you do to help provide the right care, that drives the right patient outcomes, for the right price. I look forward to seeing you virtually at the Health Cabinet Policy Summit.  

February 2022

February 2022
Putting Members First

During this first quarter of 2022, the Department will continue to pursue initiatives that achieve its mission to improve health care access, equity and affordability for the one in four Coloradans we cover while delivering value to all Coloradans.  

Our 2022 legislative agenda is a great example. It proposes to: 

  • Increase oversight over quality care for elderly Health First Colorado members who need long-term services and supports through our PACE partners. 
  • Update Health First Colorado’s rate-setting structure to increase its effectiveness, engagement and responsiveness. 
  • Bring us into compliance with federal eligibility requirements.  
  • Increase hospital pricing transparency to drive better affordability in the private sector.  

In addition to our legislative agenda, the Department has been actively engaged at every level of the Behavioral Health Transformational Task Force to determine how to best invest the $450 million in American Rescue Plan Act of 2021 (ARPA) funding to improve access, equity and the delivery of behavioral health care services across Colorado. Comprised of legislators, executive branch representatives and diverse behavioral health practitioners and experts, the Task Force came to unanimous consensus on all funding recommendations and allocations, now available in the Jan. 31 recommendations report. Look for legislation this session that turns these recommendations into action.

Also on the behavioral health front, and to achieve our goal of increasing access to behavioral health providers serving Health First Colorado members, we released a mailing in collaboration with the Department of Regulatory Affairs encouraging behavioral health providers to join our network. Behavioral health providers not currently in our network are invited to visit our Provider Enrollment website for more information on how to enroll. As well, the Department is continuing its work on four workstreams to improve the performance, accountability and partnership with the state’s Community Mental Health Centers (CMHCs), which are a pillar within our behavioral health safety net system. This includes modernizing our cost reports and our payment models, implementing universal contracts that hold the Department and the CMHCs more accountable, and reducing administrative burden.   

In addition to modernizing our CMHC payment models, our fiscal year 2022-2023 budget proposes broader, meaningful investments into value-based payments (R-6), which enable us to better reward value in care delivery – like closing disparities, enhancing member health or improving affordability. We look forward to partnering with and rewarding providers who help achieve shared goals to the betterment of the Coloradans we jointly serve.  

On Jan. 27, we presented to the House and Senate Committees of Reference at the Department’s SMART Act hearing, including an overview of environmental challenges and opportunities, priorities, regulatory and legislative agendas, and budget requests. We also invite you to review our Annual Report to hear directly from our members and to learn more about the Department.  

On behalf of our passionate Department staff and leadership, we thank you for your partnership in delivering improved health care access, equity and affordability to Health First Colorado and to all Coloradans.  

January 2022

January 2022
A Better Tomorrow for Adults and Children

With your help, we have connected Coloradans who lost their jobs during this economic downturn to public health coverage, which is an important tool in the battle against health disparities and the most important contributor to maintaining the state’s uninsured rate at about 6.6%. Specific to Colorado children, together, Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+) now cover nearly one in two Colorado children. Contributing to this reality, the number of children and parents we cover is up by almost one-third since the start of the pandemic.

After health coverage, another top priority in battling health disparities for low-income children is vaccinating them against COVID-19. Across the nation and here in Colorado, we are experiencing a frightening vaccine uptake disparity for people with lower incomes. Our 5-19-year-old members' vaccination rate is almost 17 points below all Coloradans of the same ages, and our adult members’ vaccine disparity is about 26 points below all adult Coloradans.

In our quest to overcome this important health disparity, and to encourage more providers to be part of the solution, we have received approval from CMS to further increase the Health First Colorado and CHP+ reimbursement rate for COVID-19 vaccine administration to $61.77 for the first two doses, retroactive to Sept. 1, 2021. This rate is triple the typical Medicaid vaccine administration rate and 50% above the Medicare rate. With this change, we again ask our providers to please become a Health First Colorado vaccine distribution partner. That includes Health First Colorado primary care providers, dentists, pharmacists and specialists, too. We also ask that our provider partners leverage every opportunity, in every care setting to encourage vaccinating our kids as well as families, and to encourage boosters too, which is even more important given the Omicron variant surge. An outreach toolkit is available for your use.

We also want to thank you for your partnership in addressing the impact of COVID-19 on the mental health of children, youth and adults. The behavioral health workforce challenges and appropriate care site limitations are clearly frustrating for all of us, especially as the demand for behavioral health services continues to rise. Longer term, we are confident the 19 priorities of the Behavioral Health Task Force - including the Behavioral Health Administration - and the $450 million in American Rescue Plan Act funding to transform our behavioral health system, with committee recommendations forthcoming this month, will help address these significant challenges. In the shorter term, we are collaborating bi-weekly with hospitals to help them find placements here in Colorado and across the nation for children, youth and adults awaiting appropriate behavioral health services. Concurrently, we are improving community mental health center (CMHC) cost reporting methodologies and developing a new universal contract model to help address many of the CMHC safety net system opportunities. Look for further behavioral health safety net solutions in mid-January, and please read this statement reaffirming my shared commitment with Colorado Department of Human Services Executive Director Michelle Barnes on the importance of working together to transform the behavioral system to the betterment of all Coloradans seeking such services.

As we begin the new year, I want to thank you for your collaboration in navigating the COVID-19 pandemic. 2022 will be a year of dynamic transformation, to the betterment of the children, youth and adults who rely on our services each and every day.  

December 2021 Message

December 2021
Behavioral Health Transformation

It is no secret that the COVID-19 pandemic has created a significant strain on our current behavioral health system. Addressing systemic behavioral health challenges for the betterment of the health and well-being of Coloradans requires participation and thought leadership from all state agencies and partners.  

Fortunately, HCPF and stakeholders have been working to invest over the last several years in partnerships, providers and programs to improve our Health First Colorado behavioral health system and services. Some of those investments are financially based - including increasing our annual behavioral health funding by $400 million since 2018 - an increase of over 60%. In fact, the fiscal year 2022-23 Governor’s budget submitted in November includes an additional $59 million (+6%), increasing our behavioral health funding to over $1 billion for this next fiscal year, if approved.

Recent funding increases were largely used to expand behavioral health care access and reimbursements - both critical to meeting the rising demand for behavioral health services. In fact, the Health First Colorado network of behavioral health providers has grown by 18%, or more than 1,500 providers over the last 18 months. (Thank you, RAEs, for this partnership.) And thanks to our legislative and stakeholder partners, we were also able to add an Inpatient and Residential Substance Use Disorder Treatment benefit effective Jan. 1, 2021, which served about 5,000 Health First Colorado members in its first six months. I invite all of us to celebrate this vital behavioral health benefit added during a significant economic downturn.

Concurrently, HCPF continues provider agencies to increase access for children, youth and adults to crisis services, supportive housing, residential recovery, high-intensity services and wrap-around services. We are also working on delivery system reform: integrating physical and behavioral health, as noted in the Governor’s November budget, and building out behavioral health system infrastructure, technology and workforce. We appreciate your partnership on this important work as well.

While these investments are moving the needle in the right direction, there is still far more work to do. Fortunately, from day one of the Polis-Primavera Administration, a foundation to reform Colorado’s behavioral health system was put into place through the creation of the Behavioral Health Task Force. It identified three key actions to be taken by the state: expanding behavioral health access through telehealth, implementing 19 priorities to improve Colorado’s behavioral health system and establishing a Behavioral Health Administration (BHA). Please review the November Behavioral Health Administration plan that outlines the path toward a more coordinated, patient-centered and effective infrastructure, which will help address many of our system’s current challenges.

In complement to this crucial work, the executive branch and the legislature are investing $450 million in federal American Rescue Plan Act stimulus dollars to drive behavioral health transformation for the betterment of Coloradans, our providers and our state. Look for the Behavioral Health Transformational Task Force recommendations this January.

On behalf of our passionate staff and the 1.55 million Coloradans accessing our coverage services, thank you for your partnership and leadership to help us transform Colorado’s behavioral health system.

November 2021 Message

November 2021
Investing in Transformation

The Governor’s FY 2022-23 Budget released Nov. 1 totals $40 billion with a $36.5 billion operating budget. HCPF’s operating budget represents $13.5 billion or 37% of that, while our $4 billion general fund budget request represents 30% of the state's general fund budget. The Governor’s balanced budget is prudent and fiscally responsible, doubles down on the Governor's commitment to saving Coloradans money, ensures workers can earn a living wage, and puts more money back in Coloradans’ paychecks. It combines fiscal responsibility with an historic opportunity to leverage one-time funding for health care and behavioral health system transformation thanks to federal COVID relief funds and state investments in stimulating the economy.  

HCPF’s leadership has been participating in the many discussions about what those historic, transformational investments could look like: more than $500 million in long-term American Rescue Plan Act (ARPA) transformational investments for people with disabilities through our home & community-based services (HCBS) spending plan and an estimated $450 million in ARPA dollars to drive behavioral health transformation in concert with the Behavioral Health Transformational Task Force. This important work is concurrent to the Nov. 1 release of the Behavioral Health Administration plan, which includes $3 million to invest in initiatives at the General Assembly’s direction.  

HCPF’s $4 billion general fund budget represents an increase of $343.4 million general fund over the baseline. The vast majority of this increase is to account for the expiration of the 6.2 percent federal match enhancement in the 2022/2023 fiscal year at the same time we are increasing provider rates. HCPF’s other discretionary requests are, in aggregate, budget negative - reducing expenditure by $40.5 million total funds, $4.8 million general fund. While HCPF’s budget is comprehensive, we call out below some of the budget requests that enhance value based payments, which pay Medicaid providers for value and performance versus just volume; increased county resources; and provider rate increases: 

  • R-6 Value Based Payments focuses on incentivizing affordable, higher quality and more equitable care. Currently, HCPF pays most providers for services delivered on a fee-for-service basis. The General Assembly has authorized HCPF - and CMS is strongly encouraging HCPF - to establish programs to pay for “care value” as opposed to just “care volume”. This budget request would support maternity bundled payments; primary care provider partial capitation models; model development to further improve outcomes and affordability across specialty care; and financial incentives to providers using the Prescriber Tool
  • R-8 County Administration, Oversight & Accountability provides increased support to our county partners for important administrative-related activities, including improved customer service, member eligibility and enrollment, quality improvement and meeting new administrative requirements. In addition, the request includes additional pay-for-performance funding through the County Incentives Program for counties to earn if they meet new and/or additional performance benchmarks and deliverables.  
  • R-11 Provider Rate Adjustments includes funding to address Medicaid Provider Rate Review Advisory Committee recommendations to increase and rebalance rates for specific providers while including a 0.5% across-the-board rate adjustment for all other providers. This request also furthers the Jan. 1, 2022, plan put forward by the Polis-Primavera administration and HCPF that creates a minimum $15/hour wage for direct care workers in home- and community-based settings funded through Medicaid as part of our HCBS ARPA spending plan

The annual Department budget requests are in our 2022-2023 Budget Agenda Summary. We invite you to stay updated on our HCPF Budget at our Legislator Resource Center.  

On Oct. 28, the Colorado Health Institute released the 2021 Colorado Health Access Survey report, which indicated that the state’s uninsured rate remained steady at 6.6% despite the historic economic downturn. Medicaid state and federal policies were significant contributors to that outstanding result. Conversely, this underscores the critical need for all of us to continue to work together through the end of the public health emergency (PHE) to help Coloradans stay covered as the continuous coverage provisions of the PHE come to an end.

October 2021 Message

October 2021
Recovery Powered by Inclusion

The pandemic has challenged our health care system, but it has also provided us the opportunity to innovate for a better, healthier and more inclusive future. In that spirit, I’m excited to share that we received both CMS and JBC approval of our American Rescue Plan Act Home & Community Based Services (HCBS) spending plan to enhance, expand, and strengthen Health First Colorado’s (Colorado’s Medicaid program) ability to serve members with disabilities in a home or community based setting. Many thanks to stakeholders for your collaboration throughout this process. More information is at hcpf.colorado.gov/arpa. Please join us in celebrating this accomplishment and the improvements it will create!

I also want to recognize that October is National Disability Employment Awareness Month, which commemorates the contributions of people with disabilities to our workplaces and the economy. A related initiative that is part of our HCBS spending plan includes extending and expanding the Supported Employment program, which supports Coloradans with disabilities to find and succeed in employment. As a standard, we also work to ensure employment is the first and preferred option for every member on the Developmental Disability and Supported Living Services Medicaid waivers.

Our members’ voices are vital to furthering inclusion in our programs. I had the pleasure of recently meeting with our Member Experience Advisory Council, whose insights serve as a key part of our strategic process and quest for continuous improvement. Thank you for your partnership on this important work, and look for the report from the Colorado Health Institute in October that will update our state’s uninsured rate.

To achieve the Governor’s goal of A Colorado for All, we have continued to identify our baseline health disparities data. That has helped inform our top health equity priorities: COVID-19 vaccination rates, maternal health outcomes and behavioral health outcomes. On the vaccine front, addressing the current 25-point vaccination rate gap between Medicaid members and the state population overall is critical to reducing spread, hospitalizations, and deaths among low-income Coloradans and people of color. Please feel free to incorporate this short slide presentation into your related messaging presentations. Thank you for your partnership in this key messaging to reduce avoidable hospitalizations.

On closing maternity disparities, last month, we released a first-of-its-kind Health First Colorado Maternity Report. Health First Colorado is the primary source of health coverage for more than 40% of births in the state each year. Our maternity event, which included expert speakers and panelists, identified several opportunities where we can partner with care providers, advocates, policymakers, and Coloradans to work toward improved outcomes. We also invite you to keep abreast of the good work evolving through the Behavioral Health Task Force, Behavioral Health Administration and Behavioral Health Transformational Task Force.

Thank you for all you are doing to improve the health and well-being of our Health First Colorado and Child Health Plan Plus members. We appreciate your collaborative partnership!

September 2021 Message

September 2021
Partnering to Address Health Disparities

Thank you to the 1,000 stakeholders who joined our Summer Health Cabinet Summit last month and to those who will watch the Summit sessions in the coming weeks. And thank you to the panelists who provided expert insights and thought-provoking dialogue to each of our topics: prescription drug and hospital affordability, behavioral health transformation, and health equity. The event recording and materials are posted on our Affordability website and the newly released reports – Hospital Cost, Price & Profit Review and COVID-19's Impact on Colorado Hospitals' Finances - are posted on our Hospital Reports Hub.

A top priority for HCPF remains getting our members vaccinated and therefore protected against the impact of COVID-19. Health First Colorado members (who, by definition, have low incomes) have a 25-point vaccination gap compared to the state vaccination rate. This gap is the same or smaller than the vast majority of states. Still, closing this disparity is of vital importance to reducing spread, hospitalizations, and deaths among low-income Coloradans. 

Thanks to you, our partners, we know that targeted outreach works, as evidenced by the results of three strategic initiatives: (1) Medicaid members with disabilities are now vaccinated at more than twice the rate of their counterparts; (2) homebound members are now vaccinated at twice the rate of their counterparts; and (3) the gap between Medicaid members of color and white members has been narrowed to less than 3%. The issue remains closing the vaccination gap between low-income compared to medium- and high-income Coloradans. 

Thank you, Regional Accountable Entities, community health centers, physicians, hospitals, pharmacists, and our many other valued partners. We appreciate the individual outreaches, education, and encouragement that resulted in Medicaid members getting vaccinated. Your trusted voices are critical to closing this 25-point health disparity and saving lives. 

As leaders, we are important role models. Thank you to the many hospitals that led the way and implemented employee vaccine mandates. The State of Colorado is requiring all state employees to be fully vaccinated or to test twice-weekly for COVID-19 starting Sept. 20. Also, at the request of the Governor, the State Board of Health is requiring vaccination by Oct. 31 for personnel working with Colorado’s most vulnerable as well as in settings where people receive essential health care services in order to keep Coloradans protected and save lives.  

After COVID-19 vaccination uptake, the state’s second health equity priority is maternal health. The Department is helping to lead this charge given that our safety net programs cover more than 40% of the births in the state. This event will review the findings in our newest report, Colorado Medicaid Maternity Report, followed by an expert panel discussion of the health disparity drivers and solutions to address them. Stay tuned for the imminent release of this report on our website. Looking forward to seeing you then!

August 2021 Message

August 2021
Affordability Powers Recovery

Through Medicaid and CHP+, HCPF is now providing coverage and services to more than 1.5 million Coloradans, a 21% increase since March 2020. Thank you for your partnership in providing critical services to Coloradans in need.

Covering 1 in 4 Coloradans during a fiscal downturn necessitates innovations that prudently control costs and improve health, enabling us to better protect provider reimbursements and member benefits. HCPF administration remains less than 5% of our budget, which is significantly lower than the average commercial carrier administration of more than 13%. Our efficiency enables us to allocate more than 95 cents on every dollar to care.

Our priority innovation opportunities are in the areas of long term services and supports (LTSS) as well as hospital and prescription drugs. Relative to LTSS, we received partial approval from CMS on our Home & Community Based Services (HCBS) 10% enhanced FMAP proposed spending plan, which was crafted collaboratively with more than 800 stakeholders. We are working with CMS to address their questions before the next round of stakeholder engagement.

In addition to the Hospital Transformation Program that launched in April 2021, we are also releasing hospital reports this month that analyze urban hospital costs, prices and profits as well as the impact of COVID and related federal stimulus on Colorado hospitals.

To lower prescription drug costs, we released the Affordability Module of our new Prescriber Tool in June to empower prescribers with cost insights into drug therapy options. Since 1 in 3 Coloradans either cannot fill a prescription, cut pills in half, or skip doses due to cost, this tool helps advance Gov. Polis’ quest to save people money on health care while also controlling Medicaid spend. Colorado is the first state in the nation to provide a shared Prescriber Tool that supports affordability for patients, employers and Medicaid. Via electronic health records (EHRs), 85% of Medicaid prescribers can access this tool to earn value-based payments and be part of the prescription drug affordability solution. The tool also reduces administrative burden and rework for providers and improves service to Medicaid and commercial members through e-prescribing and e-prior authorizations. In that spirit, it is critical that providers collaborate with HCPF to enable and use this new tool. Contact your EHR vendor today to make sure Colorado Medicaid Real-Time Benefit Check transactions are routing. More information on the Prescriber Tool is available on our website.

Join our August 19th virtual Health Cabinet Summit to learn more about the findings in the hospital costs, prices & profits report, updates on our state and federal prescription drug affordability strategy since the release of our January 2021 Reducing Prescription Drug Costs in Colorado Report, the Behavioral Health Administration work, and health equity opportunities. Looking forward to seeing you then!

July 2021 Message

July 2021
Partnership Powers Policy

Thank you for your collaboration on advancing policies to improve health care equity, access and outcomes while saving people money on health care this legislative session. We appreciate the hard work of our elected officials, advocates, providers and stakeholders who brought passion, insights and expertise to create effective policy.  

With your help, the Department of Health Care Policy & Financing was successful in passing our full legislative agenda to enhance telemedicine policy, build out a high performing cross-disability care coordination system, expand skilled nursing facilities where they are needed most, add remote supports for adults in home and community based services waivers, and expand our drug importation program as part of our broader affordability goals.  

We are also pleased that bills the Department supported passed, including establishing the Behavioral Health Administration, Prescription Drug Affordability Board, State Health Equity Plan and the Colorado Option. We were also pleased to see the updates to the Governor's Office of Information Technology statutes to better drive technology efficiencies, the movement of regulatory authority to the Department to support better health care billing for indigent patients, and the package of maternity health bills.  

Thank you, as well, to the nearly 800 stakeholders who helped inform the Department’s draft spending plan for the American Rescue Plan Act’s Home & Community Based Services enhanced federal match, which was submitted to the federal government in mid-June. We appreciate the 375 comments you sent and the 428 survey responses.  

For Health First Colorado (Colorado’s Medicaid program), legislation passed to allow us to also use American Rescue Plan Act funding to extend pregnancy-related and postpartum services for a full year and add secure transportation for those experiencing behavioral health crises. 

Last, I want to ask for your continued help in closing the significant health disparities in vaccine uptake for our Health First Colorado members. We appreciate your collaboration, continued targeted outreach and community-based partnership.