At a Glance is a Department of Health Care Policy & Financing (HCPF) 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 our website. Thank you for your interest!

Invitation to Annual Meeting & Update on Select Priorities 

We invite you to register for our Department of Health Care Policy & Financing (HCPF) Annual Stakeholder webinar on Aug. 27, from 8 to 11 a.m. This event will review HCPF major initiatives for fiscal year (FY) 2023-24, priority initiatives for FY 2024-25, and public health emergency (PHE) unwind insights and opportunities going forward. We look forward to your attendance and feedback. 

Transforming Behavioral Health. On July 1, 2024, years of planning finally came to fruition as new safety net provider types and payment models were instituted across the behavioral health system. Inherent in the new payment model is the Prospective Payment System, or PPS, which was built and tested over the past three years with providers, advocates, and payers. The PPS model is sustainable, reliable, data driven, nationally supported, cost-based, accountable, and long overdue. 

Comprehensive safety net providers (previously called community mental health centers) shared their “must-haves” for a payment model, and HCPF was able to meet almost all of their voiced requests through the PPS. This new payment model pays in advance instead of reimbursement, adds an increase for inflation and future costs, and accounts for new BHA compliance standards. Available only for BHA-approved safety net providers, the PPS rate is unique to each comprehensive provider and is calculated based on their actual operating costs. That includes the cost of serving people who are uninsured or underinsured and reflects the specific needs of communities across Colorado. Sustainable payment models will be key to mitigating the foreseeable changes and financial cliffs that have come with the end of the public health emergency, especially the end of federal PHE stimulus dollars.  

Health Related Social Needs. On Aug. 13, 2024, HCPF submitted a proposal to our federal partners at the Centers for Medicare and Medicaid Services to expand coverage for services that address health related social needs. If approved, Medicaid members that meet additional eligibility criteria would have coverage for the following services: 

• Housing services including pre-tenancy & housing navigation services, tenancy sustaining services, rental assistance for temporary housing or vouchers for up to 6 months (including utilities), and one-time transition and moving costs.
• Nutrition services including home delivered meals or pantry stocking, medically-tailored meals, and nutrition counseling/education. 

Thank you to all of the community partners who showed up fast and ready to help us move this policy forward at a record speed. This was only possible because state and community leaders have prioritized researching, advocating, piloting, and promoting programs that address the whole person, and recognize that housing, food security, and other social determinants are all part of achieving health and wellness. 

Advancing the Medicaid Delivery System Through ACC Phase III. The Accountable Care Collaborative (ACC) is the primary vehicle for delivering health care to Health First Colorado members, with Regional Accountable Entities (RAEs) as the central component responsible for propelling members’ physical and behavioral care coordination, case management and health. Phase III of the ACC, scheduled to begin July 1, 2025, is designed to improve access to care, health care equity, quality outcomes, and member and provider experience, while managing costs to protect member coverage, benefits, and provider reimbursements. The Request for Proposal (RFP) closed July 13, 2024, and we intend to announce contract awardees by October 2024. Thank you to the 5,700+ attendees across 135 stakeholder meetings for partnering on developing the ACC Phase III RFP over the past 18 months. More information is on the ACC Phase III webpage. 

Keep Coloradans Covered. In accordance with our February 2024 budget assumptions, Colorado’s Medicaid membership is returning to pre-pandemic levels. Our PHE Unwind was May 2023 through April 2024, plus the 90-day reconsideration period, which ended July 2024. Post PHE Unwind metrics are reflecting some of the advances made during the PHE and the PHE Unwind, to the betterment of the member experience and county eligibility processing workloads. 

• Unwind renewal approvals were within 2% of prepandemic norms (55% vs 57%), and disenrollments were as well (43% vs 41%). For the first two months post unwind (both May and June 2024 renewals), 76% of those up for renewal were approved as still eligible for Medicaid/CHP+, a significant improvement. 
• About 57% of May and June 2024 households were renewed through automation innovations (ex parte). That’s a significant and meaningful improvement over the 33% average during the PHE Unwind. This improvement is to the betterment of the member experience and county workload.
• Procedural denials have also returned to prepandemic levels, at 13% and 12% for May and June 2024 renewals, respectively. 

That said, there is still more work to do, and we are committed to completing that work. As explained in our July message, major initiatives designed to improve the eligibility process include: 

• SB22-235 County Administration of Public Assistance Programs: A County Administration Long-Term Support Plan that provides recommendations to improve county administration of eligibility and enrollment and related activities, including properly resourcing our state-county infrastructure, addressing county staff wage rate gaps, advancing the eligibility tools employed by county workers, and more. Target Completion Date: This report is due to the legislature in November 2024. 
• Improve our renewal automation rates and PEAK performance, our member digital tool.
• Improve clarity in 55 common member eligibility communications, and ultimately eligibility renewal results. Target Completion Date: December 2024.
• Through the Joint Agency InterOperability (JAI) project, we will advance county consistency through the use of shared, universal tools that support counties in eligibility task management, including new applications, renewals, case changes and other tasks; dashboarding; document capture; and related critical work. Target implementation date: Anticipated 2026 - 2027.
• The Colorado Benefits Management System (CBMS) Vision & Strategy project is driving alignment and clarity around CBMS operational advances, infrastructure, and priorities. Target completion date: June 2025.

Stabilize Long Term Supports and Services (LTSS). We continue to prioritize stabilizing the Medicaid LTSS system. This includes protecting coverage for LTSS members, paying providers timely to protect access to services, identifying and resolving known issues in the new Care and Case Management Tool (CMM), reducing case management and county backlog, and leveraging the escalation process. 

Save Coloradans Money on Prescription Drugs. We are awaiting approval of our State Importation Plan from the FDA, submitted in February 2024, to import lower-cost prescription drugs from Canada. Additional strategies HCPF has advanced to increase the affordability of prescription drugs include Medicaid value-based arrangements for specialty drugs, prescriber tools to drive affordability and quality already used by 55% of Medicaid prescribers, and policies to save Coloradans money on prescription drugs, including rebate pass through, the elimination of spread pricing (up-charging), and active engagement in the Prescription Drug Affordability Advisory Council, which advises the Prescription Drug Affordability Board. 

HCPF has moved!

HCPF has officially moved all operations to 303 E. 17th Ave., Suite 1100, Denver, CO 80203. Please be sure to update your records so you and your mail don’t end up at our prior Grant Street address.

Become a Health First Colorado Doula Provider:

Health First Colorado members are now able to access doula benefits. HCPF is working to build up a robust doula provider network, so please visit our website to learn about enrolling as a Health First Colorado doula. We also invite you to attend a stakeholder meeting about the doula benefit on Aug. 29, 2024, from 1 to 2:30 p.m. You can register for this stakeholder meeting online. 

For more information, contact hcpf_maternalchildhealth@state.co.us.

HCPF Has Moved!

HCPF has officially moved all operations to

303 E. 17th Ave., Suite 1100

Denver, CO 80203.

Please be sure to update your records so you and your mail don’t end up at our prior Grant Street address.

Bariatric Surgery Rule Change Consideration Community Meeting:

HCPF invites the public to a virtual stakeholder meeting that will present information about possible changes to the bariatric surgery rule (citation: 300.3.c). 

At the meeting, HCPF staff will review the current rule and propose possible changes to the rule. Attendees are invited to learn, ask questions, and provide initial feedback about the potential change. 

Feedback will be gathered at the meeting and via a feedback form that will be shared with attendees. 

Meeting date and time: Thursday, Sept. 12, 9:30 to 11 a.m. 

Registration and location: the meeting will be virtual via Zoom. Register in advance for the meeting. After registering, you will receive a confirmation email containing information about joining the meeting.

Meeting Accommodation and Language Access Notice: Auxiliary aids and services for individuals with disabilities and language services for individuals whose first language is not English may be provided upon request. Please notify Patrick Potyondy at patrick.potyondy@state.co.us at least one week prior to the meeting to make arrangements. 

Las ayudas y servicios auxiliares para individuos con discapacidades y servicios de idiomas para individuos cuyo idioma materno no sea inglés pueden estar disponibles por solicitud. Comuníquese con Patrick Potyondy a patrick.potyondy@state.co.us al menos una semana antes de la reunión para hacer los arreglos necesarios.

If you have general questions, please contact Patrick Potyondy at patrick.potyondy@state.co.us for more information. 

Resources for Behavioral Health Providers - New Training Library Page, Upcoming Office Hours & FAQ:

The new Training Library page is your one-stop-shop for all trainings to date featuring recordings of live trainings, links to pre-recorded trainings, and slides from each training. The page lists trainings by title and also categorizes trainings by topic to help you easily find what you're looking for:

• Behavioral Health Basics
• BHA Licensure and Approval
• Payment
• Quality Improvement and Capacity Building
• Serving Specific Populations
• Workforce

Discuss your questions with our subject matter and clinical experts - go to the HCPF Safety Net Providers webpage to register for upcoming office hours. They are an opportunity for questions and discussion about how reform initiatives will impact your organization.  

• Register for Friday, Aug. 30, at 12 p.m.
• Register for Friday, Sept 27 at 12 p.m.

Helpful FAQs on the HCPF Safety Net Providers webpage: see the most commonly asked questions from providers, covering topics including:

• BHA Licensure/Approval
• HCPF Enrollment
• Safety Net Provider Types
• National Provider Identifier (NPI)
• Billing and Reimbursement

Join the Behavioral Health Provider TTA newsletter to stay up to date.

Health-Related Social Needs Stakeholder Webinar:

HCPF invites you to an informational webinar about Health-Related Social Needs (HRSN) work at HCPF.

During the webinar, HCPF staff will review progress on the studies required by House Bill 24 - 1322 and House Bill 23 - 1300, how the two studies align and differ, and their timelines.

Feedback and questions will be gathered during the webinar, and an opportunity to submit additional questions will be provided after. After the meeting, HCPF staff will post meeting materials and provide answers to frequently asked questions on the HRSN webpage.

Webinar date and time: Wednesday, Aug. 28, 2 to 3 p.m. 

Register in advance for the webinar. After registering, you will receive a confirmation email containing information about joining the webinar.

The webinar will be offered verbally in both English and Spanish. Presentation slides will also be offered in both English and Spanish. 

Webinar Accommodation and Language Access: Auxiliary aids and services for individuals with disabilities and language services for individuals whose primary language is not English may be provided upon request. Please notify Patrick Potyondy at patrick.potyondy@state.co.us at least one week prior to the webinar to make arrangements. 

Las ayudas y servicios auxiliares para individuos con discapacidades y servicios de idiomas para individuos cuyo idioma principal no sea inglés pueden estar disponibles por solicitud. Comuníquese con Patrick Potyondy a patrick.potyondy@state.co.us al menos una semana antes del seminario web para hacer los arreglos necesarios.

For more information, contact hcpf_hrsn@state.co.us. 

Seminario web comunitario sobre necesidades sociales relacionadas con la salud

El Departamento de Políticas y Financiamiento de la Atención Médica o HCPF (Department of Health Care Policy & Financing) lo invita a un seminario web informativo sobre el trabajo sobre las necesidades sociales relacionadas con la salud o HRSN (Health-Related Social Needs) que está realizando el personal del HCPF.

Durante el seminario web, el personal de HCPF revisará el progreso logrado en los estudios que exige el proyecto de ley de la Cámara de Representantes 24 - 1322 y el proyecto de ley de la Cámara de Representantes 23 - 1300, cómo los dos estudios se alinean y difieren, y sus plazos.

Durante el seminario web se recogerán comentarios y preguntas, y después se ofrecerá la oportunidad de enviar preguntas adicionales. Después de la reunión, el personal del HCPF publicará los materiales de la reunión y responderá a las preguntas más frecuentes en la página web de HRSN, donde podrá encontrar información adicional sobre el trabajo sobre HRSN del HCPF.

Fecha y hora del seminario web: miércoles 28 de agosto de 2:00 a 3:00 pm. 

Inscripción y lugar: El seminario web será virtual y se realizará a través de Zoom. Inscríbase para el seminario web con anticipación. Después de inscribirse, recibirá un correo electrónico de confirmación con información sobre cómo participar en el seminario web.

El seminario web se ofrecerá verbalmente en inglés y en español. Las diapositivas de la presentación también se ofrecerán en inglés y español. 

Adaptación del seminario web y acceso lingüístico: Previa solicitud, se facilitará apoyo y servicios auxiliares para personas con discapacidad y servicios lingüísticos para personas cuyo idioma materno no es el inglés. Notifique a Patrick Potyondy en patrick.potyondy@state.co.us al menos una semana antes del seminario web para hacer los arreglos necesarios.  

Si tiene preguntas generales, envíe un correo electrónico a hcpf_hrsn@state.co.us para solicitar más información. 

HCPF Annual Stakeholder Webinar:

We invite you to register for our HCPF Annual Stakeholder Webinar on Aug. 27, from 8 to 11 a.m. This event will review HCPF major initiatives for FY 2023-2024, priority initiatives for FY 2024-2025, and public health emergency unwind insights and opportunities going forward. We look forward to your attendance and feedback at this event.

Registration and other materials will be posted on our website.

Doula Stakeholder Meeting:

HCPF invites stakeholders to a virtual meeting that will present several updates on the doula benefit and give the chance to both ask questions and provide feedback. 

At the meeting, HCPF staff will first cover the ongoing work HCPF have been completing since the benefit went live on July 1, 2024. Staff will answer questions after a short presentation covering the updates. Attendees will also have a chance to provide feedback on the benefit. 

Feedback to specific questions will be gathered in the meeting. Attendees will also have a chance to share feedback via a form that will be shared after the meeting.

A recording of the meeting will be posted to the HCPF doula webpage.  

Webinar date and time: Thursday, Aug. 29, 1 to 2:30 p.m. 

Register in advance for the meeting. After registering, you will receive a confirmation email containing information about joining the meeting.

The webinar will be offered verbally in English. In the meeting, attendees will have the ability to use automatic translated captioning. Spanish will be available. Presentation slides will also be offered in both English and Spanish. 

Webinar Accommodation and Language Access: Auxiliary aids and services for individuals with disabilities and language services for individuals whose primary language is not English may be provided upon request. Please notify Patrick Potyondy at patrick.potyondy@state.co.us at least one week prior to the webinar to make arrangements. 

Las ayudas y servicios auxiliares para individuos con discapacidades y servicios de idiomas para individuos cuyo idioma principal no sea inglés pueden estar disponibles por solicitud. Comuníquese con Patrick Potyondy a patrick.potyondy@state.co.us al menos una semana antes del seminario web para hacer los arreglos necesarios.

If you have general questions, please email hcpf_maternalchildhealth@state.co.us for more information.