|
Upcoming Events and Helpful Resources
|
| Health First Colorado videos for use in waiting rooms and other areas members visit are available for download on our website. |
New to PEAK or Need a Refresher?
The Intro to PEAK and Application Walk-Through recorded webinars are available anytime. For more information and trainings, visit the
PEAK Outreach Initiative website.
|
Public Rule Review Opportunities
Anyone interested in a one-on-one discussion with Department staff about upcoming rules is invited to attend the Department's
Public Rule Review Meeting. Information is available on the
Public Rule Review Meetings webpage.
For more information, or to be added to the Medical Services Board email distribution list, please contact
Chris Sykes.
|
Employment Opportunities
Applying for state government jobs is easy. Applications are electronic, you will receive updates, and you do not need to answer any written questions until it is determined that you meet the minimum qualifications.
Check out the
website for State of Colorado jobs including the Department of Health Care Policy & Financing jobs.
|
|
 |
|
Welcome to the September 2019 edition of
At a Glance!
Thank you for your interest!
|
| A Message from the Executive Director |
This month I'd like to address the second pillar of our new Department performance plan:
Medicaid Cost Control - Ensure the right services for the right people at the right price
We take our responsibility to our members very seriously. This responsibility includes ensuring both appropriate program and benefit use and ensuring the long-term sustainability of Colorado Medicaid, which is growing at an annual claim trend of 9.19 percent on a per-member-per-month basis and 4.3 percent on a total cashflow basis. If we take steps now to safeguard utilization and control costs, we are ensuring Colorado Medicaid will be strong and viable for years to come.
These measures, outlined in our Department performance plan, support the Medicaid Cost Control pillar:
- Achieve $6,780 per member per year ($565 per member per month) in average annual Medicaid per capita total cost of care, excluding all supplemental and other financing payments.
- Work with the Regional Accountable Entities (RAEs) to better coordinate care for our members with the most complex needs. Identify the members who would benefit the most from RAE support, and identify the areas where Medicaid health care costs are rising by September 1, 2019.
- Work with the RAEs to identify programs that will improve Medicaid member health and better control costs by March 1, 2020.
The entire performance plan, including more detail on the five pillars and each of these measures, is available on our website.
Thank you for your partnership and commitment helping the Department improve health and control costs across the Medicaid program.
Kim Bimestefer
|
|
Non-Emergency Medical Transportation Vendor Transition
|
|
IntelliRide is managing all Health First Colorado Non-Emergent Medical Transportation (NEMT) services as of September 1, 2019.
IntelliRide serves these counties:
- Adams
- Arapahoe
- Boulder
- Broomfield
- Denver
- Douglas
- Jefferson
- Larimer
- Weld
Since the transition, IntelliRide has been experiencing higher than normal call volume and hold times. The Department is working closely with IntelliRide, providers and members to resolve individual issues as quickly as possible. IntelliRide has doubled the number of required call center agents for both the phone and chat feature, and allowed call centers in other states to take calls from Colorado. IntelliRide can be reached at 1-855-489-4999.
IntelliRide is asking that callers:
- Listen carefully to phone tree options.
- Wait to call for rides that are more than a week away. This will lower call volume and help to prioritize members with immediate transportation needs.
- Provide specific details (member name and Health First Colorado ID, date and time of incident, and destination) when registering a complaint.
- Consider scheduling rides using IntelliRide's website: https://gointelliride.com/colorado/
The Department and IntelliRide are working diligently to make sure members can get to and from appointments without a disruption in services.
|
Child Health Plan Plus Dental Benefit Update
|
|
Please help us spread the word! Beginning October 1, 2019, dental benefits will be available for all Child Health Plan Plus (CHP+) moms, who
will have access to dental benefits during pregnancy and up to 60 days postpartum. Health First Colorado prenatal women have had dental benefits since 2014.
Dental Care is safe and important to have during pregnancy!
This is a new benefit for CHP+ moms, and we want to make sure they get the care they need. Pregnancy can affect oral health so visiting the dentist during pregnancy is important.
Women with
CHP+ coverage should contact DentaQuest customer service at 1-888-307-6561, TTY 711, or send an email through the Member Access Portal at [email protected] if they need help making a dental appointment or finding a provider.
|
|
Dr. Lisa Latts Named Chief Medical Officer
|
|
Dr. Lisa Latts is our new Chief Medical Officer. Dr. Latts is a national leader in health system transformation and value-based care, with a focus on innovative health improvement and next generation population health.
Prior to joining the Department, Dr. Latts was the Deputy Chief Health Officer for IBM Watson Health.
Dr. Latts has been an Assistant Clinical Professor at the University of Colorado Hospital since 1998. She will continue in this role as she serves as the Department's Chief Medical Officer.
|
|
Hospital Transformation Program Update
|
Update on HTP communications archives
The Hospital Transformation Program (HTP) website was restructured to give more transparency to historic communications between the Department and stakeholders. In addition to archives of past editions of the HTP Newsletters, the website now includes, and will continue to include, additional communications regarding HTP. Please see the HTP website for more information.
Scoring Framework Posted
The Scoring Framework
, the revised version of how measures will be scored, has been posted to the HTP website. Hospitals will be evaluated on both state and local measures, with local measures being chosen by hospitals to specifically reflect the needs in their community as identified through the Community and Health Neighborhood Engagement (CHNE) process. The document outlines the program pieces that have associated penalties and incentives, and at what levels.
The proposal
for calculating the total required effort for measures is that each hospital will be required to work on a set of statewide and local measures equal to 100 points. The number, mix and points per measure will vary according to hospital size, defined by bed count or specialty type. As it has been throughout the development of the HTP, the development process has been open, transparent and inclusive of stakeholder and community input and feedback.
We'd like to recognize the work of the Colorado Hospital Association (CHA) and the various workgroups who participated in this important collaboration. Please feel free to reach out to
the HTP team
with any questions or comments.
Rural Support Fund
The Department is beginning the process of holding preliminary meetings with a small group of hospitals to discuss the Rural Support Fund component of the HTP. Pending approval from the Centers for Medicare and Medicaid Services, this part of the program will be under 1115 waiver authority to provide additional resources for non-resort, critical access and frontier hospitals. Additional information about this component of the program will be forthcoming and can be found in future editions of the HTP Newsletter.
|
|
Partnerships to Improve Population Health
|
|
Emergency Triage, Treat and Transport Payment Model
|
The Department is aware that 911-response agencies in Colorado are participating in a Medicare payment model called Emergency Triage, Treat and Transport (ET3).
ET3 is a five-year payment model through the Center for Medicare and Medicaid Innovation (Innovation Center) that provides greater flexibility for ambulance care teams to address some non-emergency health care needs of Medicare beneficiaries following a 911 call.
Though ET3 is specifically a Medicare payment model, the Department looks forward to working with ET3 participants in Centers for Medicare and Medicaid Services (CMS) Innovation Center Learning System activities. 911 ambulance response teams across Colorado can find
information on this initiative on the ET3 website .
|
|
Delivery System Innovation
|
| Substance Use Disorder Benefit Update |
Public Comment Period
The 1115 Substance Use Disorder waiver public comment period began on August 25, 2019 and closed on September 27, 2019. Two public hearings were held during September. Stakeholders submitted comments by mail and email. The Department appreciates the feedback received on the waiver. Staff are engaged in next steps to move forward with waiver submission.
Substance Use Disorder Capacity Building Workgroup
The Substance Use Disorder Capacity Building Workgroup will examine the capacity for treatment services across the continuum in the state. The group will identify areas where there is insufficient capacity for services and develop a plan to address deficiencies. Once the plan has been drafted, it will be shared with stakeholders who will be invited to provide comment and suggestions.
Benefit Implementation
The Department continues to work on other issues, such as provider licensure and training, to prepare for covering new Substance Use Disorder services. The Department will conduct regular stakeholder meetings to prepare for offering the new benefit. Those meetings will be announced
on our website and through the waiver initiative newsletter.
|
| Electronic Visit Verification Good Faith Exemption & Implementation Update |
The Department is pleased to announce that CMS has approved Colorado's request for a Good Faith Effort Exemption.
Exemption for Live-In Caregivers
On August 8, 2019, the Centers for Medicare and Medicaid Services released an informational bulletin providing additional guidance on the applicability of Electronic Visit Verification (EVV) to Medicaid services provided by live-in caregivers. The new guidance permits states to exempt live-in caregivers from the EVV mandate.
The Department will work with stakeholders as we develop system and policy solutions to exempt live-in caregivers.
EVV Implementation for Other Caregivers
The Department will not mandate EVV on January 1, 2020, and providers will not be required to participate on that date. A new date for the EVV mandate will be communicated to stakeholders in early 2020. The Department anticipates that EVV will be mandated in Colorado in late summer 2020.
EVV system implementation, training, and vendor interfacing will proceed on the current project schedule. Providers are strongly encouraged to participate in EVV beginning October 2019. Early adoption of EVV will produce valuable data for system modification and policy development. The timeframe between system launch and the EVV mandate is referred to as the soft-launch.
The Department will update stakeholders on the project timeline in the months to come. Please continue to attend stakeholder meetings to provide feedback to the Department and stay up to date on project developments.
|
| Disability Determination Application Process |
Arbor/ARG will only accept applications from approved Medical Assistance Sites/County Human Services offices. Arbor/ARG will no longer accept applications from non-Department approved sources.
This is not a new process and has been outlined within the scope of the contract that the Department holds with Arbor/ARG.
The Department discovered there were some exceptions being made to allow the acceptance of third-party applications previously; however, the process has been clarified with Arbor/ARG in their contract this past spring.
|
|
|
The Colorado Department of Health Care Policy & Financing complies with applicable federal and state civil rights laws and does not discriminate on the basis of race, color, ethnic or national origin, ancestry, age, sex, gender, sexual orientation, gender identity and expression, religion, creed, political beliefs, or disability. Learn more about our Nondiscrimination Policy.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-221-3943 (State Relay: 711).
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-800-221-3943 (State Relay: 711).
|
|
|
|
At a Glance
