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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Investing in Transformation
The Governor’s fiscal year 2022-23 Budget released Nov. 1 totals $40 billion with a $36.5 billion operating budget. HCPF’s operating budget represents $13.5 billion or 37% of that, while our $4 billion general fund budget request represents 30% of the state's general fund budget. The Governor’s balanced budget is prudent and fiscally responsible, doubles down on the Governor's commitment to saving Coloradans money, ensures workers can earn a living wage, and puts more money back in Coloradans' paychecks. It combines fiscal responsibility with a historic opportunity to leverage one-time funding for health care and behavioral health system transformation thanks to federal COVID-19 relief funds and state investments in stimulating the economy.
HCPF’s leadership has been participating in the many discussions about what those historic, transformational investments could look like: more than $500 million in long-term American Rescue Plan Act (ARPA) transformational investments for people with disabilities through our home and community-based services (HCBS) spending plan and an estimated $450 million in ARPA dollars to drive behavioral health transformation in concert with the Behavioral Health Transformational Task Force. This important work is concurrent to the Nov. 1 release of the Behavioral Health Administration plan, which includes $3 million to invest in initiatives at the General Assembly’s direction.
HCPF’s $4 billion general fund budget represents an increase of $343.4 million general fund over the baseline. The vast majority of this increase is to account for the expiration of the 6.2% federal match enhancement in the 2022-23 fiscal year at the same time we are increasing provider rates. HCPF’s other discretionary requests are, in aggregate, budget negative - reducing expenditure by $40.5 million total funds, $4.8 million general fund. While HCPF’s budget is comprehensive, we call out below some of the budget requests that enhance value based payments, which pay Medicaid providers for value and performance versus just volume; increased county resources; and provider rate increases:
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R-6 Value Based Payments focuses on incentivizing affordable, higher quality and more equitable care. Currently, HCPF pays most providers for services delivered on a fee-for-service basis. The General Assembly has authorized HCPF - and CMS is strongly encouraging HCPF - to establish programs to pay for “care value” as opposed to just “care volume.” This budget request would support maternity bundled payments; primary care provider partial capitation models; model development to further improve outcomes and affordability across specialty care; and financial incentives to providers using the Prescriber Tool.
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R-8 County Administration, Oversight & Accountability provides increased support to our county partners for important administrative-related activities, including improved customer service, member eligibility and enrollment, quality improvement and meeting new administrative requirements. In addition, the request includes additional pay-for-performance funding through the County Incentives Program for counties to earn if they meet new and/or additional performance benchmarks and deliverables.
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R-11 Provider Rate Adjustments includes funding to address Medicaid Provider Rate Review Advisory Committee recommendations to increase and rebalance rates for specific providers while including a 0.5% across-the-board rate adjustment for all other providers. This request also furthers the Jan. 1, 2022, plan put forward by the Polis-Primavera administration and HCPF that creates a minimum $15/hour wage for direct care workers in home and community-based settings funded through Medicaid as part of our HCBS ARPA spending plan.
On Oct. 28, the Colorado Health Institute released the 2021 Colorado Health Access Survey report, which indicated that the state’s uninsured rate remained steady at 6.6% despite the historic economic downturn. Medicaid state and federal policies were significant contributors to that outstanding result. Conversely, this underscores the critical need for all of us to continue to work together through the end of the public health emergency (PHE) to help Coloradans stay covered as the continuous coverage provisions of the PHE come to an end.
Kim
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COVID-19 Vaccines for Children Ages 5-11:
This week the Centers for Disease Control and Prevention (CDC) announced the Pfizer vaccine is approved for emergency use for children ages 5-11.
As a partner, we encourage you to help connect Health First Colorado and CHP+ members and their families to information about the vaccine. A toolkit to assist partners with outreach has been developed. The Colorado Department of Public Health and Environment (covid19.colorado.gov/kids-vaccines), Centers for Disease Control and Prevention (www.cdc.gov) and the American Academy of Pediatrics’ Healthy Children (www.healthychildren.org) have updated information about the vaccine.
Many medical offices will soon begin offering COVID-19 vaccines for children ages 5 to 11 years. Pediatric providers are encouraged to enroll as COVID-19 vaccine providers with CDPHE to help ensure access to the vaccine. Primary care providers can receive grant funding ranging from up to $60,000 to $120,000 (depending on practice size) to support the distribution of COVID-19 vaccines.
Additional resources are below:
Initial demand for the children’s vaccine has been very high, and although many slots this weekend already are full, Colorado will have ample supply of the vaccine. Updated information about the vaccine is available at covid19.colorado.gov/kids-vaccines.
Thank you for continuing to help keep Colorado safe during this pandemic.
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Public Comment: Medicaid Statewide Managed Care System:
The Department has opened a 30-day public comment period to collect feedback on the revised Medicaid Statewide Managed Care System rule. The comment period will run from Oct. 25, 2021 through Nov. 24, 2021. Existing rules regarding Medicaid managed care programs have been revised to reflect the changes for Phase II of the Accountable Care Collaborative.
All comments received related to the rule revisions during this public comment period will be reviewed by the Department to assist in the determination of what further revisions, if any, to incorporate into these documents prior to rulemaking.
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Connect for Health Colorado Recruiting Advisory Group Members:
Connect for Health Colorado is recruiting health coverage guides, consumer advocates, and carrier representatives for multiple vacancies on its Board Advisory Group!
The Connect for Health Board Advisory Group convenes a variety of stakeholders to use their real-world experience to maximize the customer experience on the Exchange. This group of insurance brokers, health coverage guides, consumer advocates, and other health policy experts informs Connect for Health Colorado’s high-level policy decisions and provides feedback on customer engagement.
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It's Open Enrollment in Colorado!
For those who aren’t already covered by job health insurance, Health First Colorado or Medicare, now is the time to sign up for a health insurance plan for 2022 coverage through Connect for Health Colorado. This year, many individuals, families and small business owners shopping for health and dental plans can expect more plan choice and financial help. You can sign up for a health insurance plan during the Open Enrollment Period, which runs through Jan. 15.
- Most current customers are eligible for plan renewal, which means that their health insurance plan will automatically renew on Dec. 1 for 2022 coverage.
- After Dec. 1, customers have until Dec. 15 to update their account and change their plan as needed for coverage starting Jan. 1.
- If you sign up for a plan or change your plan between Dec. 16 and Jan. 15, your coverage will begin Feb. 1, 2022.
To find out whether you qualify for additional savings on health insurance plans, how much financial assistance you can receive and to see all the plans available to you, contact Connect for Health Colorado at ConnectforHealthCO.com or by calling 855-752-6749.
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Broadband Discount Program:
Please help us spread the word about the Emergency Broadband Benefit Program (EBB). It gives a temporary discount on monthly broadband bills during the COVID-19 pandemic.
Anyone who gets cellular from the Lifeline program, free and reduced-priced school lunch or school breakfast program, SNAP, or Health First Colorado may qualify. People who have recently lost their job or had a large loss of income, or who receive Federal Pell Grants may also qualify.
People who qualify can get:
- Up to $50 per month discount on broadband service or up to $75 per month discount if their household is on Tribal lands
- A one-time discount of up to $100 for a laptop, tablet, or desktop computer.
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Sign Up for the ARPA Project Pulse Newsletter:
The Department is implementing a multitude of projects to expand, enhance, and strengthen the Home and Community-Based Services (HCBS) system from fall 2021 through spring 2024 tied to federal funding in the American Rescue Plan Act (ARPA). This newsletter will serve as a source for key updates on all project planning and implementation, stakeholder engagement opportunities, and other topics of interest related to the funding.
We anticipate the newsletter to launch later this fall/winter and to be sent out monthly. In the meantime, please visit and bookmark the ARPA webpage for all the latest information and updates.
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Reproductive Health Care Program Update:
Senate Bill 21-009, Reproductive Health Care Program, requires the Department of Health Care Policy & Financing to cover access to family planning for people with undocumented status. The Department is working on implementing this bill, but there will be a short delay because of the Department’s COVID-19 public health emergency responsibilities.
The original timeline for full implementation was January 2022. Because of the delay, we expect the bill to be fully implemented by July 2022.
During the delay, people with undocumented status can get family planning help through Title X Family Planning Clinics.
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In September 2021, there were
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