|
Policy priorities and partnerships past the pandemic
Thank you for your partnership in helping Keep Coloradans Covered as the state begins to act upon renewal determinations starting in May, after a pause of more than three years and in accordance with federal action mandating all states to do so. In March, HCPF, in collaboration with our county partners, began sending renewal notices to members whose renewal anniversary is in May; this process will continue month by month through April 2024 to re-determine the eligibility status of all 1.78 million Medicaid and CHP+ members. As of March 24, about 65,000 households were up for coverage renewal in May. Early reports show that our automation efforts over the last year resulted in about one-third, or 21,500 households, being auto-renewed (ex parte), meaning they do not need to take any action to stay covered. The remainder, around 43,500 households, will need to take action when they receive their renewal notice electronically or through the mail in an envelope with red lettering reading - “URGENT - PLEASE REPLY”. They will need to complete their renewal paperwork online at co.gov/PEAK, in the Health First Colorado app, or by mail. Members must sign and return their paperwork by the deadline listed on their renewal.
Partners, thank you for fulfilling your role to help Keep Coloradans Covered through this important chapter. Hundreds of providers and community organizations have aligned to increase member outreach, resulting in a 34% increase in members who signed up for emails and texts so we can reach them with important Medicaid and CHP+ renewal messages. We sincerely appreciate the collective, collaborative, united approach to executing on this important campaign to Keep Coloradans Covered. Please continue to help educate members by:
This topic and more was featured at last month’s Health Cabinet Summit, which included 21 speakers sharing insights on prescription drug affordability, rural hospital investment opportunities, hospital affordability, value based payments and an update on the end of the federal public health emergency. We invite you to visit our website to review Summit materials or watch the recording.
Also at this Summit:
-
We were joined by an expert panel to take a closer look at hospital affordability and community responsiveness. In 2020, hospitals invested 7% of their patient revenues ($965 million) in community benefits, which is significant, appreciated and valued. At the same time, opportunities remain to strengthen hospital accountability to engage, review and incorporate community input into how to invest their community benefit dollars. HB 23-1243 Hospital Community Benefit seeks to improve the alignment between community feedback and hospital spending.
-
HCPF released hospital accountability and affordability resources, including the Hospital Insights Bulletin, the Breakeven Analysis tool and the Hospital Transparency Scorecard.
-
This Hospital Insights Bulletin serves as an overarching summary of six recent releases on Colorado hospital financials. This consists of an analysis of the quality of hospitals’ Price Transparency postings; a new tool for and analysis of hospitals’ breakeven rates; a preview of profits and reserves information for Colorado’s major hospital systems in 2022; and three recently released financial reports on costs, prices, profits and community benefit, with links provided here: Colorado Healthcare Affordability and Sustainability Enterprise (CHASE) Annual Report, the Hospital Expenditure Report and the Hospital Community Benefit Accountability.
- The Breakeven Analysis tool provides better insights into what hospitals need to charge commercial carriers in order to offset the underpayments of public payers. Colorado ranks sixth in the nation for the highest hospital prices and fourth for both the highest patient services profits and total profits, which incorporate investment earnings. Both are indicators of price reduction opportunities. This tool allows carriers, employers, other payers and communities to negotiate price reductions with their hospital partners in a more informed way.
-
The Hospital Transparency Scorecard shows 26.5% of Colorado hospitals have an overall quality rating of Good, while 47.0% ranked as Fair and 26.5% ranked Poor. Note that SB 23-252: Hospital Price Transparency strengthens hospital compliance incentives with the federal requirement to post hospital prices by health plan, which is critical to improving these compliance statistics and ultimately achieving the goals and outcomes of price transparency.
Related, HB 23-1226: Hospital Transparency And Reporting Requirements seeks to advance hospital financial transparency by enabling access to quarterly - or more timely and therefore meaningful - financial information which will also facilitate earlier engagement to support struggling hospitals; evaluation of the affordability impact of physician acquisitions; insights into profits and reserves leaving the state; executive compensation; improved Board-CEO alignment with community interests, and more.
Additionally at the summit, our session on prescription drug affordability highlighted that in 2021, nearly 10% of Coloradans were unable to fill prescriptions due to cost, and that prescription drug costs are the leading contributor to rising health care costs. HB 23-1201 Prescription Drug Benefits Contract Term Requirements seeks to address this by requiring pharmacy benefit managers and insurance carrier middlemen to only charge consumers the amount they paid or less, thereby eliminating spread pricing, or up-charging. Attendees polled at the summit indicated they were most excited about spread pricing policy as a way to save money on prescription drugs. For more on HCPF’s legislative agenda, please visit our Legislator Resource Center.
Following our March 15 Summit, we hope to see you at our April 12 HCPF Maternal Health Equity Webinar. At this webinar, we will review our recently released Maternal Health Equity Report on maternal health during the COVID-19 pandemic, the lived experience of members and HCPF’s roadmap to improve maternal health care and equity. The event will include remarks by U.S. Health & Human Services Regional Director Lily Griego, member and provider experiences, and thoughts from community partners. Register today to join this important conversation on improving health outcomes and care for the 43% of Colorado births we cover.
In other developments at the Capitol, HCPF is very appreciative of Governor Polis’ budget, the difficult decisions made by the Joint Budget Committee, and the legislature’s work to finalize the budget including continued investments in health care. Some of the highlights from HCPF’s FY 2023-24 budget, awaiting General Assembly approval, include:
- 3% across-the-board provider rate increase, on top of this year’s 2% increase
- 16% rate increase to primary care medical providers participating in alternative payment models to reward better care, healthier outcomes and affordability
- Continued increased wages for providers caring for people with disabilities
- Incentive payments for rural providers
- $21 million for counties to support coverage continuity through the end of the public health emergency
- Authority to eliminate co-pays for most Medicaid benefits
We thank you and our many partners for all you do every day to care for and support our Medicaid and CHP+ members, to Keep Coloradans Covered, for collaborating to drive health care affordability, for increasing Medicaid member access to care, and saving Coloradans and our employers money on health care.
| 
