The Colorado Hospital Association (CHA) is putting policies around workforce support and regulatory streamlining at the top of its 2023 legislative agenda.
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During a virtual call with members and stakeholders on December 7th, CHA Vice President of Legislative Affairs, Joshua Ewing, outlined the agenda in a preview of the upcoming legislative session.
Ewing said CHA will continue pursuing measures to grow and support the healthcare workforce, including legal protections against assault and violence and safety measures in the healthcare work setting.
CHA is looking to increase funding for the state’s rural healthcare workforce pipeline initiative, Senate Bill 172. The bill was only funded at $1.2 million annually instead of the initial funding request of $5 million.
The Colorado Rural Health Center will introduce legislation that would expand the list of providers eligible for remote patient monitoring (RPM) reimbursement under Colorado Medicaid, a measure CHA is closely tracking and endorsing.
CHA also hopes to streamline the current regulatory environment by eliminating duplicative reporting requirements, through the repeal of one measure and the alignment of community engagement efforts.
CHA is looking to repeal the Hospital Charge Report, a reporting requirement put in place before the establishment of the state’s all-payer health claims database. Ewing indicated the database makes the charge report a redundancy and that the requirement is long overdue for repeal.
The state should also align requirements aimed at nonprofit hospitals through the Community Health Needs Assessment, public health agencies through the Public Health Improvement Plan, and hospitals through the Hospital Transformation Program to reduce the administrative and reporting overlap, according to Ewing.
Speaking to State of Reform after the call, Ewing said the measure would expand much-needed support for rural patients and providers.
“What it means for the hospital setting is once you’re discharged after a procedure, you get to go home and instead of having to come back in for that follow-up appointment 24, 48, 72 hours later, [ and] they send you home with a cuff,” Ewing said. “It takes your vitals and reports back to the nurse on duty. And if you need to come in, you can, but it’s a way to extend the reach of the providers within that hospital.
Folks tend to do better at home. They’re more comfortable [and] it’s a better setting for them. And so ideally, they’re getting better at home. And for rural folks, it means that they don’t have to travel great distances to go back for that follow-up appointment, but we can do it remotely. And so it’s a commonsense approach that helps our workforce but also is really patient focused.”
Ewing said 2022 is on pace to be the worst financially performing year for Colorado’s hospitals in recent history. Patient revenues have not kept up with costs, as operational expenses were up 10.3% from the previous year. Operating margins are down 49% to 5.2%.
Coloradans spent the second lowest amount on hospital costs in the country in 2020, saving $22.5 billion dollars over the past decade. Without additional policy support, maintaining the state’s affordability track will be difficult in an inflationary environment, according to Ewing.
Based on the budget presentation from Gov. Jared Polis in November, Colorado is expected to propose in 2023 the elimination of all Medicaid copays with exception to emergency department visits in place of an effective rate increase, an additional 0.5% rate increase across the board to providers, and increased funding to connect rural providers to the health information exchange.
Legislators are also expected to introduce measures eliminating the Colorado Indigent Care Program in place of a more permanent program and prohibiting health plans from white bagging, according to CHA’s legislative preview.
The results of the 2022 midterm elections gave Democrats more seats in both the House and Senate, adding 5 and 3 seats respectively. This gives Democrats a 46 to 19 majority over Republicans in the House and a near-two-thirds majority in the Senate (23 to 12).
Ewing said he is looking forward to the session and engaging with the legislature’s 31 new members on the critical policy issues impacting hospitals and patients.
“Yeah, I’m always excited,” Ewing said about the upcoming session. “I see this here as a great opportunity to continue the really important conversation about our healthcare workforce, [and] talk about some commonsense reforms on the regulatory side of the equation.
I don’t know how big of a topic healthcare will ultimately be, especially as compared with some of the more recent legislative sessions. But it’s always an opportunity and regardless of where it falls in political priorities, healthcare will continue to be a top issue for our state. It’s something that impacts everybody and we need to be continually thinking about how we can improve.”