A Message from Executive Director Kim Bimestefer 

Thank you for your partnership in another unprecedented year for health care. Together, we are now successfully serving 1.74 million Coloradans, representing an additional 490,000 people — an increase of 39% since the start of the pandemic. Related, H.R.2617, the federal budget signed into law on Dec. 29, 2022, indicates that beginning April 1, 2023, states can start disenrolling individuals who no longer qualify for Medicaid through the eligibility redetermination process. In partnership with the counties, and after many months of planning and preparation, Colorado will take 12 months (14 months including noticing) to complete this process, leveraging the member’s annual renewal date and our modernized, member-centric processes. We are analyzing the related guidance from CMS received on Jan. 5 and will make any refinements to our plans, accordingly. With continuity of coverage top of mind, we are collaborating with Connect for Health Colorado and others to connect members who are no longer eligible for our programs to other affordable health coverage. More than 550 community partners joined us at our Jan. 25 Community Partner webinar to learn more; we will be posting the recording soon and please visit our website to help us achieve our shared goal of keeping Coloradans covered through this transition.

At our Jan. 12 SMART Act hearing, we shared more about HCPF priorities, our legislative agenda, performance against published goals and more. For further details, please visit our website. We also welcome your review of our FY 2021-22 annual report. Amidst the unprecedented growth in membership during the COVID-19 Public Health Emergency (PHE), we kept Health First Colorado per member per month cost trends flat while evolving innovations that drive industry transformation, improve quality, reduce disparities and improve the health of our members. Our leadership in driving affordability will continue to help us manage our own budget (about 30% of the state’s overall budget), while helping save Coloradans and employers money on health care as well.

As we begin the legislative session, feel free to visit 2023 Legislative Agenda Overview to learn more about our emerging legislative agenda, which currently includes:

To save Coloradans, the state and our employers money on health care, on Dec. 5, the Polis-Primavera administration and HCPF submitted Colorado’s proposal to the U.S. Food and Drug Administration (FDA) to import prescription drugs from Canada. The plan identifies 112 drugs with an average savings of over 60% that could be available through this program, once approved by the FDA. Additionally, Colorado Medicaid executed its third pharmaceutical value-based contract. These contracts will help deliver savings to taxpayers, state and federal budgets in the form of manufacturer refunds if the respective drug does not meet expected health outcomes for Medicaid members who are taking them. Last, a huge thank you to the more than 10,000 Health First Colorado prescribers (44%) who are using the affordability module of our prescriber tool. Through emerging value-based payment methodologies, we are taking the necessary steps now to share the millions in savings generated through the tool with providers starting next fiscal year.

Thank you for your continued partnership, and best wishes for a healthy, rewarding, transformational 2023!