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Other highlights of our Annual Webinar include:
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. More information is available on our PHE website. Some key metrics include:
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Unwind renewal approvals were within 2% of prepandemic norms (55% vs 57%), and disenrollments were as well (43% vs 41%). Since then, renewals have improved significantly: In May, 80% of renewals were approved (after 60 days of the 90 day reconsideration period); In June, 79% of renewals were approved (after 30 days of the 90 day reconsideration period), and in July, 78% remain covered. These percentages continue to increase over the next 90 days, during the reconsideration period.
- Automation is critical to improving the member renewal experience and reducing county workloads. In May 59%, June 56% and July 62% of household renewals were completed through automation innovations (or 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. (Note: ex parte can only occur on renewal approvals, not denials).
- Procedural denials are now below the 12% prepandemic levels, at 9% for May renewals (after 60 days), 10% for June (after 30 days) and 10% for July.
As noted in our Improving Performance Across Numerous Metrics chart on this webpage, all metrics are headed in the right direction. Performance is getting better, but we still have a lot of work to do.
Leveraging American Rescue Plan Act (ARPA) for Long Term Transformation. HCPF is on track to leverage one-time federal stimulus funds for long term transformation to the betterment of our members. We have completed 92% of the 61 projects; thank you to the almost 11,000 partners who engaged in our stakeholder meetings to frame the goals and focus areas associated with this work. We are pleased that more than 90% of our funds are directly benefiting the community (with 3.5% for administration). We have spent 74% of the $550 million to date. You can find more information on our website.
Transforming Behavioral Health. HCPF continues to collaborate with the Behavioral Health Administration (BHA) to strengthen Colorado’s Behavioral Health Safety Net System. This includes a new set of safety net services and connecting new provider types to new Medicaid payment models to ensure sustainable access to a full continuum of BH care for Medicaid members.
These changes were specifically designed to expand the provider network and develop an updated model for Comprehensive Providers (previously called community mental health centers, or CMHCs), and a new payment model for small and medium sized providers. These Essential Safety Net Providers offer care coordination, one or more of a select set of behavioral health services, and often specialize in services for certain populations like children in foster care, individuals with co-occurring disabilities, or people experiencing homelessness. These providers have long been part of the safety net, but previously did not have access to safety net funding. Starting July 1 of this year, Essential Providers are eligible to apply for an enhanced payment if they can demonstrate their ability to meet a safety net standard of care.
As of August 23, BHA has received 327 total applications from providers to become Comprehensive or Essential Safety Net Providers. So far BHA has issued 18 Comprehensive Provider approvals and 87 Essential Provider approvals, and HCPF has successfully enrolled 5 Comprehensive Providers across 28 locations and enrolled 60 Essential Providers. If you are interested in becoming a safety net provider, please visit the BHA Behavioral health licensing, designation and approvals website to learn more!
Webinar attendees also shared their views via the poll below on the behavioral health areas they would like more focus on from HCPF, in our efforts to help transform Colorado’s BH system.
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