Home Birth-Midwives Stakeholder Engagement Questions and Answers
This webpage summarizes unanswered and common stakeholder questions received during Colorado Department of Health Care Policy & Financing’s (HCPF) stakeholder engagement on April 10, 2025 regarding expanding Health First Colorado member’s access to midwives to include home birth settings.
Below each item, the Department has provided an interim response.
Important Note: There are several stages of policy development and implementation. Any responses on this webpage represent a snapshot of the Department’s position as of June 12, 2025 and should not be read as final policy determination.
Where can I find policy changes and updates shared in the stakeholder meeting, held on April 10, 2025?
The April 10 meeting presentation and recording are posted on the home birth-midwives stakeholder meeting webpage.
Can you provide some data on the safety of home births with Certified Professional Midwives (CPM) and Direct-Entry Midwives (DEM) providers?
Planned home births in the United States have outcomes comparable to planned birth center births for low-risk birthing people. The Department of Regulatory Affairs (DORA) and the Colorado Department of Public Health and Environment (CDPHE) are responsible for oversight and regulation of midwife services in Colorado. Ultimately, HCPF defers to DORA and CDPHE on this being an allowable and safe method of delivery in the state.
- Additional information can be found on DORA’s Direct-Entry Midwifery web page and CDPHE’s Birth Centers Health Facility web page.
Can you provide more information about how the analysis on malpractice insurance was completed? Did those completing the analysis engage with midwives?
HCPF engaged with several audiences regarding our analysis on whether or not we would exempt CPM/DEMs from having malpractice insurance, as all other enrolled providers are required to have. This included feedback from birthing members, obstetric providers broadly, various midwives and facilities. While we have heard from the CPM/DEM provider community that this presents an insurmountable financial barrier to provider enrollment, the majority of the feedback and analysis supports retaining this requirement. We engaged the Colorado Attorney General’s (AG) Office for legal counsel regarding requiring malpractice insurance for CPM and DEM providers in home birth settings. Background information on the policy, including feedback provided by stakeholders during the policy development process, was shared with the AG’s Office and informed their analysis.
Do providers who deliver babies in hospitals receive a different reimbursement rate than providers who deliver babies at home? How can interested stakeholders give input on Health First Colorado rate calculations?
HCPF pays for birth services in two ways: provider and facility fees. Currently, home birth provider fees are the same as hospital-based providers for low-risk birthing people. For the facility fee, HCPF does not currently have a home birth reimbursement rate but will be engaging the community and other states with home birth “facility” reimbursement methodologies to explore options through our Medicaid Provider Rate Review Advisory Committee (MPRRAC). Rate calculations are reviewed by the MPRRAC per statute. Stakeholders who wish to participate in the rate review process and give feedback can find more information on the MPRRAC web page.
For more information contact
HCPF_Stakeholders@state.co.us
Department of Health Care Policy and Financing (HCPF)