At a Glance is a Department of Health Care Policy & Financing (Department) publication that provides information on major initiatives, policy changes and program updates. Feel free to share At a Glance with your colleagues. Find previous editions of At a Glance on the Department website at Colorado.gov/hcpf/publications. Thank you for your interest!
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A Message from the Executive Director |
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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.
Kim
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Register Now for HCPF's Annual Stakeholder Webinar:
Please register to join Health Care Policy & Financing leaders for a virtual webinar on July 19 from 9-11 a.m. This event will share what we accomplished together last year, address priorities for next fiscal year, and invite stakeholder feedback and comments.
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Child Health Plan Plus Changes:
As of July 1, 2022, Colorado's Child Health Plan Plus (CHP+) program made the following changes:
- Friday Health Plans is no longer a Colorado CHP+ Managed Care Organization (MCO)
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Postpartum coverage is expanded for members from 60 days to 365 days after they give birth or when their pregnancy ends
- The annual enrollment fee has been removed
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Health First Colorado Buy-In Program for Working Adults with Disabilities Allowing Individuals 65 and Older to continue to enroll for Benefits:
As of July 1, 2022, CBMS will be updated to allow no maximum age limit for the Buy-In Program for Working Adults with Disabilities (WAwD).
Individuals must still meet all eligibility qualifications for the program. Working individuals must have a disability determination through Social Security or the state disability determination vendor, ARG. Individuals 65 and older who do not have a disability determination must submit a disability application to ARG.
For more information, please view these resources:
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Email Address Change:
The email address for Action Review Group (ARG) disability application submissions changed July 1.
remains the state's contractor for disability applications; the submission email address is the only thing that has changed.
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Mental Health Parity Report:
The annual Mental Health Parity Report for state fiscal year 2021-2022 was published on June 1 as required by C.R.S. section 25.5-5-421. The Department created this year’s annual report following a process for determining mental health parity compliance based on the federal parity guidance outlined in the Centers for Medicare & Medicaid Services’ Parity Toolkit and in accordance with all state requirements. The report’s format and the process followed to create it was significantly updated to provide greater clarity and more thorough evaluation of policies and procedures.
The report includes findings from the external quality review audit which evaluates Regional Accountable Entity (RAE) and Managed Care Organization (MCO) policies and procedures in operation. The Department also contracted with Myers and Stauffer to perform an independent assessment of the processes followed for the creation of the 2022 Mental Health Parity Report.
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Legislative Session Wrap-Up:
The Department is happy to announce that the 2022 legislative session was a bipartisan success for our legislative agenda. All of the Department’s agenda items for this year were successfully passed into law, including bills to
- Support the Program of All-Inclusive Care for the Elderly (PACE) oversight and accountability
- Increase hospital price transparency in the state
- Stimulus for rural hospitals
- HB 22-1329, this year’s Long Bill, which funds the Department's important work for the next fiscal year
As you can see, we had a very busy legislative session! For more information on each of our agenda bills for this year and other major bills impacting the Department, check out our 2022 Legislative Wrap-Up. And for more information on the Department’s fiscal year 2022-23 budget, visit our Long Bill Overview.
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Update Your Address Messaging Toolkit:
The purpose of this toolkit is to provide our community partners, stakeholders, and advocates with messaging and resources to encourage Health First Colorado and Child Health Plan Plus (CHP+) members to update their contact information. This toolkit is particularly important to prepare members for upcoming updates to the renewal process for Health First Colorado.
This toolkit was a collaborative effort among the Department of Health Care Policy & Financing and advocates, with review and input from Health First Colorado and CHP+ members. Partners using this toolkit may modify the language to fit their specific communication vehicles; however, the messaging in these resources should remain the same to ensure consistency.
Please note that highlighted text indicates areas where partner organizations should insert their organization’s name and information if they provide enrollment assistance. Contact information for a partner organization that could help with enrollment can also be inserted. Please delete these lines if they do not apply to your organization.
English and Spanish versions of all messaging and graphics are available.
Thank you for helping us spread the word!
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Antiviral Information for Providers:
If your facility is not currently enrolled in COVID-19 Antiviral Distribution, we would like to encourage you to participate and complete this form to initiate the process. Interested sites must already be licensed by the Colorado State Board of Pharmacy to dispense outpatient medications.
For new information on the federal Test to Treat program, refer to ASPR’s fact sheet. In this program, people can get tested for COVID-19 and—if they are positive and can get therapeutic treatments—receive a prescription from an on-site health care provider and have their prescription filled all in one location. Patients can also bring their own positive result from at-home tests or outside testing locations. To indicate interest in this program, email cdphe_dcphr_covidtherapeutics@state.co.us.
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COVID-19 vaccine updates:
The CDC has approved an additional booster dose for people who may be at higher risk of severe outcomes from COVID-19. People over the age of 50 can now get an additional booster four months after their prior dose to increase their protection.
The Food and Drug Administration (FDA) fully approved the Moderna COVID-19 vaccine on Jan. 31, 2022. The Moderna vaccine has been available under emergency use authorization (EUA) for individuals 18 years of age and older since Dec. 18, 2020.
The COVID-19 Pfizer booster is approved for anyone 12 and older. The Colorado Department of Public Health & Environment encourages all Coloradans age 12 and up to get a booster dose as soon as possible if it has been at least six months since they got their second dose of Pfizer or Moderna, or at least two months since they got the Johnson & Johnson vaccine.
As a reminder, children ages 5-11 are eligible for the COVID-19 vaccine. Vaccines and boosters are common practice in routine childhood vaccination. Many vaccines require multiple doses at specific intervals to be most effective. Anyone with questions about boosters is encouraged to speak with their health care provider.
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