The Colorado Legislature is set to adjourn on Wednesday after a busy session largely focused on the development of the Behavioral Health Administration, health care support for older Coloradans, and health care billing and payment reform.
See our coverage of some of this legislation, as well as an insightful conversation with incoming BHA Commissioner Dr. Morgan Medlock and an overview of the recently finalized state budget, below.
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State of Reform
1. Legislation on health care billing, price transparency move forward
Two bills moving through the legislature propose significant reforms to billing and payment in state health care. HB 1284 would prohibit health plans from charging individuals out-of-network rates for emergency services in an effort to align state policy with the federal No Surprises Act. HB 1325 would develop parameters for alternative payment models for primary care—part of a broad initiative to implement VBC in the state’s commercial health insurance market.
We’re also keeping tabs on a bill that would prohibit hospitals from collecting debt from patients for services provided while the hospital was noncompliant with federal hospital price transparency laws. While more optimistic about the bill after amendments were added, CHA remains concerned about the bill, saying it would “encourage costly litigation and incentivize patients to avoid paying their health care bills.” The original bill has been approved by both chambers and awaits House approval of Senate amendments.
2. Colorado takes steps to improve elderly care
Policymakers have heavily prioritized improving health care for older Coloradans this legislative session, with the most important development being the passage of a bill to modernize the Older Coloradans Act earlier this year. Legislators continue to focus on this demographic and are advancing legislation to fortify the pipeline of geriatric care providers, improve support for Coloradans who use wheelchairs, and increase grants to support aging Coloradans throughout the state.
To promote the goals of Colorado’s Strategic Plan on Aging, legislators are working on a slew of bills including SB 189, which creates a training program to augment the geriatric provider workforce. Lawmakers also passed HB 133, which raises the minimum wage for nursing home workers to $15 per hour. These policies aim to address the state’s significant shortage of providers specializing in care for the elderly—something that’s especially pertinent for the state with the second-fasted growing elderly population in the country.
3. Q&A: BHA Commissioner Dr. Morgan Medlock outlines plan for new administration
“We shouldn’t be creating anything for our communities without our community. Nothing for us without us. That is really what we believe in as an administration,” incoming BHA Commissioner Dr. Morgan Medlock recently told State of Reform. Upon the passage of HB 1278—which details the responsibilities of the BHA—Medlock said the administration will immediately begin accepting applications for its Advisory Council.
The council, consisting of 20 members from diverse backgrounds throughout the state, will assist the administration in developing its Strategic Plan, which Medlock said will be released at the end of the year. In July, the administration will launch a website for stakeholders to submit feedback and an online public-facing treatment directory. Medlock also noted the upcoming creation of two new positions within the administration: a Workforce Development Officer and an SDOH Policy Advisor.
4. Finalized state budget prioritizes pandemic recovery
Gov. Jared Polis signed Colorado’s highest-ever $36.5 billion state budget on April 25th, appropriating $17.6 billion GF to health care-related areas in FY22-23. CHA, which worked closely with the Joint Budget Committee on portions of the budget’s health spending, told State of Reform the budget represents a “COVID hangover.” The budget allocates $5.4 billion GF to higher education and $311 million GF to workforce in order to bolster the state’s health care workforce as it continues to struggle with the impacts of COVID.
The $36.5 billion budget doesn’t include the $1.5 billion Colorado is receiving through ARPA, $530 million of which will be used for implementing the state’s HCBS spending plan, approved by CMS last fall. The plan will fund efforts to improve crisis and acute care services, improve access to HCBS for underserved populations, and expand emergency preparedness.
5. Medicare and inflation
In his most recent piece, State of Reform columnist Jim Capretta evaluates how the 8.5% inflation rate over the past year—the highest in four decades—could impact Medicare. Changes to the program include higher market basket base payments to providers serving Medicare patients, physician reimbursements that aren’t reflective of the growing inflation rate, and significant increases to Medicare Advantage payments.
Capretta also notes that increased inflation will hit the pocket books of Medicare beneficiaries, since higher Medicare costs will translate to higher premiums and deductibles. While acknowledging that future inflation is uncertain, he urges policymakers to plan for a continued high inflation rate and its impacts on federal programs like Medicare. “What is clear is that planning should begin now, including by policymakers responsible for Medicare, for a scenario in which high inflation continues beyond 2022.”