Advancing Rural Health Care and Prescription Drug Affordability

The Department is collaborating to invest in rural health care to increase care access, improve member health, close disparities, save people money on health care and improve rural provider sustainability. 

In partnership with the Polis-Primavera Administration, the General Assembly, and our rural providers and stakeholders, the Department is taking multiple steps to achieve these shared goals:

• Rural Connectivity & Access to Virtual Care. To minimize the digital divide between rural and front-range providers, the state has connected 86% of rural safety net providers to the statewide health information exchange (HIE) and custom data analytics. This is important progress toward enabling all critical access hospitals and rural health clinics to connect to health information exchange services, supporting the Polis-Primavera Administration's health priorities. In partnership with the Office of eHealth Innovation (OeHI) and as supported by the General Assembly, a total of $17.4 million in federal matching funds will be invested over four years. This connectivity supports rural member access to virtual care, helps keep care local by supplying rural health care providers with access to critical data and technology, improves care coordination and enhances the efficiency of care delivery to rural patients.

• Stabilizing Rural Hospitals & Improving Affordability Capabilities. In partnership with our hospitals and the Colorado Hospital Association, the five-year Hospital Transformation Program (HTP) is designed to improve the affordability and quality of hospital care by tying provider fee funded hospital payments to quality- and affordability-based initiatives. A critical component of the HTP is the Rural Support Fund, which invests $12 million each year over five years ($60 million) to help 23 critical access and rural hospitals modernize, better serve their communities and prepare for value-based payments.

• Improving Rural Access & Affordability. In partnership with the Polis-Primavera Administration and the General Assembly, we are leveraging American Rescue Plan Act funding through Senate Bill 22-200, which created the Rural Provider Access and Affordability Stimulus Grant Program. Through this program, the Department will allocate about $10 million in grant payments to qualified rural hospitals. Grant payments will be equally allocated into two categories: affordability initiatives and care access initiatives. The Department will administer this program with the advice and recommendations of the Rural Provider Access and Affordability Stimulus Advisory Committee.

We are also investing in the health care workforce to expand access to care across the state, including in our rural communities. Together, we expanded our provider network by more than 25% 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, 2022, 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 caring for our members, reducing disparities, improving quality and increasing care access. 

Additionally, we continue important work to Save People Money on Health Care, with a special focus on the leading contributor to rising health care costs – prescription drugs. Americans pay two to three times the prices available in other countries for the same drugs. Colorado’s Canadian Importation Program, an initiative managed by HCPF, is poised to save consumers and employers an average of more than 60% on prescription medications through this emerging program. Drug importation from Canada will allow Colorado consumers and employers to pay a fair price for their medications, safely and in compliance with all federal safety guidelines. In August, the Polis-Primavera Administration and the Department announced a major milestone in the development of this program – executed contracts with key supply chain partners that will help Colorado operationalize the importation of lower cost medications from Canada. The next steps include negotiations with drug manufacturers and the submission of a comprehensive Section 804 Importation Program (SIP) application to the Food and Drug Administration (FDA) for approval. 

Thank you again for your partnership in caring for our members while improving health care access, quality, equity and affordability across Colorado.

Understanding Your Rights--Videos and Resources for Members in English and Spanish:

Please share this information with members and your networks and stakeholders who serve members:

Do you get long-term services and supports through a waiver? (Here is a list of Health First Colorado waivers.) Do you have questions about your rights under these waivers? 

If so, please watch our short, animated videos:  

• Understand your rights under these waivers (length: 2 minutes, 38 seconds)
• Know what rights modifications are, and how they work (length: 4 minutes, 13 seconds)

Learn about the Home and Community-Based Services (HCBS) Settings Final Rule and how it affects you. Find more resources on self-advocacy and supported decision-making for members receiving HCBS on this resource sheet. 

If you have questions about your rights in the waiver program, contact

HCPF_STP.PublicComment@state.co.us.

Entienda sus derechos como miembro de una exención de servicios y apoyo a largo plazo (videos)

¿Recibe servicios y apoyo a largo plazo a través de una exención? (Aquí encontrará una lista de las exenciones de Health First Colorado.) ¿Tiene preguntas sobre sus derechos en relación con estas exenciones?

Si respondió “Sí”, vea nuestros videos cortos animados.

Estos videos pueden ayudarle:

• a entender sus derechos de acuerdo con estas exenciones
• a saber qué son y cómo funcionan las “modificaciones a los derechos”; y
• a aprender sobre la regla final sobre los entornos de servicio y cómo le afectan.

Haga clic en sus derechos (duración: 2 minutos, 18 segundos) y en “modificaciones a los derechos” (duración: 4 minutos, 48 segundos) para ver cada video. Encuentre más recursos sobre la autodefensoría y el apoyo en la toma de decisiones para las personas que reciben servicios en el hogar y en la comunidad (HCBS, en inglés) en esta hoja de recursos.

Si tiene preguntas sobre sus derechos en el programa de exención, escriba a HCPF_STP.PublicComment@state.co.us.

New Department Senior Executive Team Leaders:

The Department is pleased to announce additions to our Senior Executive Leadership Team.

New State Medicaid Director

The Department is pleased to announce that Adela Flores-Brennan, MA, JD has been selected as our Medicaid Director, reporting to Executive Director Kim Bimestefer. In this role, Adela will also assume the role of Office Director, leading our newly titled Health Policy Office (formerly Health Programs Office), which designs, maintains and oversees Health First Colorado and CHP+ medical policies and contracts. Adela joined the Department in May 2022 and had been serving as the Interim Benefits Division Director and the Deputy Chief Administrative Officer. 

Adela brings over 20 years of experience in Colorado public policy and advocacy and a deep understanding of health issues including Medicaid, CHP+, private insurance, family economic self-sufficiency, state tax and budget policy, and federal oversight. More recently, Adela served as executive director of the Colorado Consumer Health Initiative (CCHI), which led numerous major health policy changes to benefit Colorado consumers during her tenure. She has successfully partnered with community members, policymakers and regulators at the state and federal levels to advance policies that expand access to quality and affordable health care while protecting consumers. Adela has also served on the boards of directors for Connect for Health Colorado, Center for Improving Value in Health Care (CIVHC) and Colorado Access. Please join us in congratulating Adela on her new role.

New Office of Medicaid and CHP+ Behavioral Health Initiatives and Coverage

We are pleased to announce the formation of a new office within HCPF - the Office of Medicaid and CHP+ Behavioral Health Initiatives and Coverage. Please join us in congratulating Cristen Bates, who has been promoted to Director of this new HCPF office. This office will govern HCPF’s specific behavioral health policies, benefits, special projects and strategies that were previously part of our Health Programs Office. Accordingly, Cristen and HCPF’s behavioral health managers and staff will remain in their same positions but within this new office, under Cristen’s leadership. 

The timing of this new office is very intentional. Given the unprecedented and historic changes both underway and forthcoming to transform the state’s behavioral health system, this new HCPF office under Cristen’s leadership will ensure that HCPF is fully aligned and engaged to support the Behavioral Health Administration (BHA) and its vision to achieve transformative goals while also improving HCPF’s focus and ability to meet the expectations of our advocates, legislators, providers, counties and other stakeholders in the provision of Medicaid and CHP+ behavioral health services. This includes implementing elements of the statewide behavioral health transformative initiatives attributed to HCPF while ensuring that HCPF continues to improve the behavioral health access, quality, equity and service provided to Medicaid and CHP+ members, who now number 1.67 million Coloradans. 

Cristen will also hold the role of Deputy Medicaid Director, ensuring close partnership with Adela as the Medicaid Director and Director of HCPF’s Health Policy Office. Cristen is a dedicated public health executive with 20 years of experience serving the community. Her behavioral health expertise and passion will serve her well in this important role. Cristen has been with HCPF for three years, and previously served as the Director of Strategy, Communications and Policy for the Office of Behavioral Health within the Department of Human Services. Cristen will now be a member of HCPF’s Senior Executive Leadership Team in this new role, reporting to Executive Director Kim Bimestefer, and joining other Department Office Directors (i.e., Tom Leahey, Pharmacy Office; Bonnie Silva, Office of Community Living; Adela Flores-Brennan, Health Policy Office; Charlotte Crist, Cost Control & Quality Improvement Office; Ralph Choate, Medicaid Operations Office; Bettina Schneider, Finance Office; Parrish Steinbrecher, Health Information Office; Tom Massey, Policy, Communications & Administration Office).