Gov. Polis’s “roadmap” to lower health care costs

On Thursday, Colorado Gov. Jared Polis and Lt. Gov. Dianne Primavera released “The Polis-Primavera Roadmap to Saving Coloradans Money on Health Care.” The plan will guide the state’s Office of Saving People Money on Health Care, which Primavera leads and which Polis created via executive order earlier this year.

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The plan is a two-tiered list of “action steps” that are tied to specific policy items and outcome goals. One tier is focused on short-term efforts and the other is focused on mid- and long-term efforts.

“In the short term, we are taking concrete steps to lower the cost of health insurance and out-of-pocket costs,” the plan reads. “In the longer term, we are making investments in preventive care, expanding access to comprehensive primary and behavioral health services, and helping providers use data more effectively to ensure Coloradans get the care they need when and where they need it.”

The steps in the graphic below make up the short-term tier.

 

Each step is broken down into more specific actions; most are tied to legislation that’s in play this session:

Polis signed a hospital-transparency bill into law at the end of last month.

A bill to establish a reinsurance program is evolving and making its way through the Legislature.

A Senate bill that the plan says would enable the Summit County Peak Health Alliance to launch, so consumers can “collectively negotiate their health insurance plans,” passed out of the Senate recently and is now up for consideration in the House Rural Affairs & Agriculture Committee. The plan also mentions “an innovative approach to negotiating the state employee health plan” and strengthening the Division of Insurance oversight.

The “Lower Hospital Prices” goal doesn’t seem to be tied to specific legislation. Rather, it reads like a series of pledges:

“We will shift the way we pay for care to reward better patient outcomes, instead of the broken “fee-for-service” model where we pay for the number of procedures patients receive. We also will engage communities directly to give them a seat at the table and ensure that hospital services and actions truly reflect community needs. Finally, we will fully leverage the state’s All Payer Claims Database, which has the best health care cost information in the state to help us understand why costs are rising. We will make sure this dataset is as complete as possible, so we can identify effective ways to lower costs.”

To reduce out-of-pocket costs, the plan mentions the governor’s support for a bill that would protect consumers from balance billing, and another that would create a new license and licensure requirements for freestanding emergency departments.

Along with the promise to “fully leverage the State’s purchasing power to drive better deals and lower prescription drug costs for Coloradans,” the plan mentions a bill to ask the federal government for permission to start importing prescription drugs from Canada and a bill to increase price transparency for prescription drugs.

Some long-term goals in the plan are also tied to specific legislation that’s up for consideration this session:

• HB 19-1004 would launch a state health insurance option and has crossed over to the Senate;
• HB 19-1233 is aimed at increasing the utilization of primary care providers; and
• HB 19-1095 and SB 19-052 look to strengthen the provider workforce.

Long-term goals that aren’t tied to specific legislation include increasing access to healthy food, improving vaccination rates, supporting “innovative health care delivery and reform models,” and reforming the behavioral health system. The plan mentions that Gov. Polis will establish a task force for behavioral health this month.

Each step is explained in more detail in the report, and desired outcomes are detailed in the report’s summary. Read the report in its entirety here.