5 Things Colorado: Polis’s budget, Lawmakers talk 2022 session, Leveraging purchasing power


Eli Kirshbaum


Last month’s 2021 Colorado State of Reform Health Policy Conference saw numerous forward-thinking and productive conversations around how to improve the state’s health care system. A big thank you to all of our speakers and everyone who attended the event! Read about some of the event highlights below.

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Eli Kirshbaum
Health Policy Reporter   

1. Legislators on what’s ahead in health policy

Among the 13 legislators who spoke at last month’s conference were the four health policymakers on our Afternoon Keynote — a video of which is available here. Future priorities highlighted during the discussion include Sen. Fields’s call for an “integrated approach” to bolstering the health care workforce and Rep. Soper’s demand for greater transparency in the health care system.

During our Democratic panel, Rep. Sirota said to keep an eye out for 2022 bills emerging from the Behavioral Health Transformational Task Force‘s interim work. During our Republican panel, minority party leaders called for more thorough deliberation and stakeholder involvement in policymaking following the “disappointing” 2021 session.


2. Polis prioritizes behavioral health, HCBS, and affordable housing in budget proposal

Gov. Polis’s $40 billion FY 2022-23 budget proposal directs $13.5 billion to HCPF and $717 million to CDPHE. This represents a respective 2% and 4.6% increase in these departments’ budgets compared to last year’s proposal.

The governor is calling for $550 million in ARPA-supplemented funds to address behavioral health care gaps and $400 million to increase access to affordable housing. The proposal’s $530 million plan to “transform” home and community based services — which will implement almost 70 projects over three years — includes an increase to a $15 per hour minimum wage for the HCBS workforce.


3. Leveraging purchasing power to control costs in Colorado

As the largest health care payer in the state, HCPF is in a unique position to drive value and affordability in care. As HCPF Executive Director Kim Bimestefer explained during our “Changing purchaser strategies for controlling health care costs” panel at last month’s conference, the agency pays facilities to do specific things like shut down cost-increasing standalone emergency rooms and to add more behavioral health beds in order to incentivize quality outcomes.

On the same panel, Claire Brockbank spoke about how Peak Health Alliance is using its purchasing power to reduce health care costs in Colorado communities. Gregory Tung, PhD, detailed the initiative he led at the Colorado School of Public Health to estimate the total cost of health care in Colorado — which he estimates to be around $38.3 billion. Watch the full conversation here.


4. DORA prepares to finalize Colorado Option design

The implementation process for the Colorado Option is well underway. DORA will submit a revised 1332 waiver to CMS on Nov. 30 after its public comment period ends Nov. 15, with an anticipated CMS approval in August of 2022. After meeting with stakeholders over the past few months, DORA has also released updated draft regulations for the standardized plan design and network adequacy requirements. These must be finalized by Jan. 1, 2022.

State leaders praised the equity-focused standardized plan design process at last month’s conference. Amanda Massey, executive director of the Colorado Association of Health Plans, said plans remain concerned about meeting premium reduction targets within the timeline provided by HB 1232 — especially when factoring in the state benchmark health insurance plan’s newly approved essential health benefits.


5. Pfizer’s Bhash Parasuraman on the future of gene therapy

In the latest edition of our virtual “Leadership Series,” we hosted a conversation on the future of gene therapy with Bhash Parasuraman, vice president of value and access for rare disease and internal medicine at Pfizer. Parasuraman spoke with Host DJ Wilson about the promise of gene therapy for treating rare diseases, how to increase access to these treatments, and the policies she thinks need to be put in place to support them.

Parasuraman believes we might see more of these “promising” gene therapies come to market within the next decade. To increase affordability, she says the US needs to implement innovative payment models for these therapies: “These are going to be more expensive and that’s going to create some budget challenges, particularly for Medicaid … There needs to be mechanisms or policy changes in place to allow for different payment models.”