Understanding HCPF Resource Needs & Protecting Our Children

HCPF’s budget hearing is scheduled for Dec. 21, all day. Thank you in advance for your support of our $14.9B total funds and $4.43B General Fund request, 96% of which goes to our valued providers to help provide care to the one in four Coloradans we are honored to serve. Four percent of these funds are allocated to administration expenses, such as our incredible, dedicated staff and our valued, contracted partners to help us meet the needs of our members. You can find more information on HCPF’s budget at our legislator resource center.

Together, Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+) cover more than 40% of children and more than 40% of births in the state. The number of children we cover in Health First Colorado is up by almost one-third since the start of the pandemic. Thank you to our hospitals and all medical providers, who are simultaneously responding to an especially challenging RSV season, the flu and COVID-19. Vaccination is the best way to protect children from these and other preventable infections. Consider the below actions you can take to help us achieve shared goals.

1. Please promote flu and COVID-19 vaccines, with specific focus on the omicron booster as well as all routine childhood and adolescent immunizations. You can use the resources in these CDPHE toolkits on flu, COVID-19 and RSV and childhood and adolescent immunizations. Everyone 5 and older who has completed a COVID-19 primary vaccine series should get an omicron vaccine to increase their protection against the variants circulating in Colorado right now. And please leverage every opportunity when a patient is in front of you to discuss the importance of vaccination; even if someone said “no” before, they may say “yes” this time or be more open to the conversation. They may also not know they are due for a vaccine or booster.
2. Provider leadership, please encourage your providers and staff to get their flu and COVID-19 shots.

Health First Colorado & CHP+ cover the full cost of all vaccines for members. Additional information on flu vaccines is at fluvaxcolorado.org. Learn more about COVID-19 vaccines and boosters and where to find them. Those who need help making a vaccine appointment should call 1-877-268-2926. Health First Colorado members who need help finding a ride to a vaccine appointment can use the Non-Emergent Medical Transportation benefit. Also, as you know, HB22-1401, which was effective Sept. 1, 2022, requires health facilities and their owned PCPs to meet patient needs, including for vaccination and testing.

This influx of patients with RSV, flu and COVID-19 is also adding to the already strained health care workforce, especially for the hospitals and pediatricians who treat children. Thank you in advance for your assistance on the above initiatives, which not only protect Colorado children, but also support our health care delivery system. In complement, we ask for your partnership in growing our health care workforce as well as the child care workforce (which helps women get back into the workforce), by printing and displaying these time-limited training opportunity communications in patient waiting rooms, exam rooms, and areas of your business operations frequented by Coloradans: hfcgo.com/assistance. Additionally, CDPHE's Healthcare Workers Recruitment and Re-engagement Fund supports the re-entry of health care professionals back into the workforce. Please visit the website for more information.

Thank you for your continued partnership in helping us cover and care for low-income Coloradans and people with disabilities, and best wishes to you and yours for a healthy, safe, and inspiring holiday season! 

Governor Letter to Congressional Delegation on PHE End:

As you know, the Department is readying for the end of the PHE and plans to take the full 12-14 months after the end of the PHE to redetermine eligibility in order to promote coverage continuity. However, enhanced Medicaid federal funding match will end the quarter the PHE ends. We thank Governor Polis for writing to our Congressional Delegation to request Congress add provisions to the federal budget bill to ensure that states can fund coverage while accomplishing PHE unwinding activities. The letter also requested funding for health care workforce initiatives. This letter was shared with other states. For more information on the Department's PHE planning, please visit our PHE planning webpage.

ACC Phase III Stakeholder Engagement:

The Department created the Accountable Care Collaborative (ACC) in 2011 to deliver cost-effective, quality health care services to its Health First Colorado members and to improve the health of Coloradans. The ACC features Regional Accountable Entities (RAEs) operating in seven regions.

Current contracts between the Department and the RAEs will end on June 30, 2025. The Department has developed goals and priority areas for improvement and innovation intended to better align with our modernized mission, advances made by our sister agencies, and stakeholder input received over the past several years. Additional information is available on the ACC Phase III webpage and in a fact sheet available on the webpage.

The Department, in partnership with the Colorado Health Institute (CHI), is pleased to be collaborating with stakeholders to discuss the vision for this next phase, referred to as Phase III. We are committed to receiving input from diverse perspectives through accessible, equitable, and productive engagement.

Dates are set for the first two Listening Sessions. We invite you to join us! Both sessions will feature the same agenda, so choose the meeting that is most convenient for your schedule. These sessions will take place virtually and will feature interpretation services.

• Dec. 20: ACC Listening Session #1 (12-1:30 p.m.)
• Jan. 10: ACC Listening Session #2 (6-7:30 p.m.)

An agenda and registration link for the Listening Sessions will be available in the coming days. Look for additional opportunities to engage over the next three months, including a public survey and other avenues to provide written feedback. Details will be available on the ACC Phase III webpage and shared in future newsletters. 

Department Annual Report:

The Department's Annual Report to the Community is now available. This report illustrates the many ways we serve Coloradans every day. We invite you to review it and celebrate all that we accomplished together this past year.

New Tools - Preparing for Renewals Partner Kit:

The Department has launched a partner communications toolkit to aid in preparing for the end of the PHE - Preparing for Renewals. This new toolkit includes a section on renewal process education that explains key terms and provides sample notices so partners can see exactly what the member will see when they go through the renewal process. In addition, both partners and members can view short videos in English and Spanish on key actions: updating an address, completing the renewal process, and transitioning to other coverage if a member no longer qualifies.

Upcoming Webinar:

The Department will be hosting an informational session on preparing for the end of the Public Health Emergency. This webinar is geared toward community partners such as advocacy organizations, providers, and community organizations who may provide other assistance to Health First Colorado or CHP+ members (housing, social services, etc). The content includes an overview of communication resources for partners to assist members in preparing for and taking part in the renewal process. We’ll also discuss transitions in coverage for members who may no longer qualify for state-administered programs.

When: Jan. 25, 2023, 1 - 2:30 p.m. Mountain Time

Topic: PHE Unwind Webinar | Community Partners & Advocates

Register in advance for this webinar: Zoom Registration

After registering, you will receive a confirmation email containing information about joining the webinar.

eConsult Platform Informational Update:

The Department is implementing a statewide Medicaid electronic consultation platform called the eConsult Platform. This platform will promote the Department's mission to improve health care equity, access and outcomes for the people served.

The eConsult platform will enable asynchronous (store and forward) clinical communications between a Primary Care Medical Provider (PCMP) and a specialist provider. The PCMP will be able to transmit an electronic clinical question to a specialist and medical information will be reviewed by the specialist provider. The specialist provider will be able to review the case without the member being present. The specialist provider then provides electronic medical consultative guidance that

assists the PCMP in the diagnosis or management of the member’s health care needs or facilitates the appropriate referral for a face-to-face visit with a specialist provider when clinically appropriate.

The Department is currently in the evaluation and negotiation phase of the procurement and expects to have an eConsult vendor selected by the end of 2022.

Anticipated Timeline

• Mid-spring/summer 2022 - Invitation to Negotiate (ITN) Posted and Vendor Selection
• Fall/winter 2022 - Contract Negotiations
• Winter 2023 – Centers for Medicare and Medicaid Services (CMS) Review of Contract
• Spring/summer 2023 - Implementation Activities
• Late summer/early fall 2023 - eConsult Platform Go Live

Note that the timeline is subject to change without prior notice and is only provided as a reference.

For more information, visit the eConsult Platform webpage or email HCPF_econsult@state.co.us.

Open Enrollment Has Begun

Open Enrollment for health insurance has begun! This year’s Open Enrollment

period began on Nov. 1, 2022, and ends on Jan. 15, 2023. Thanks to the

Inflation Reduction Act, there continue to be more savings for more people. Folks

can see how much financial help they qualify for and review plans before enrolling by

using our Quick Cost Plan Finder Tool.

Exciting New Health Insurance Option for Coloradans who are Undocumented

OmniSalud is a new health insurance program that provides Coloradans who are

undocumented with a safe way to compare affordable health insurance plans and sign

up on a secure online platform. Thanks to a new Colorado law passed in 2021, every

company that sells health insurance in the state has to offer plans with a specific set of

lower, fixed costs and make them available to everyone – no matter their

documentation status. We strongly encourage folks to sign up with the help a certified

expert who can walk them through the application and help them understand

how to use their health insurance, all free of charge. To learn more about OmniSalud

visit our website. You can also find an OmniSalud expert and make an appointment.

Web and print versions of our resources on Connect for Health Colorado and

OmniSalud are available to you free of charge through our Open Enrollment

Online Toolkit and our Online Print Materials Store.