When this session began, there was much concern about the slow economic recovery and the inability of the state’s revenues to keep up with the increasing demand for state services. The frustration of trying to balance the budget and to make difficult program reductions was growing, as was the partisan divide.
But two important factors seemed to turn things around. First, the revenue boost in the March forecast allowed legislators to avoid cutting popular programs, especially helpful in an election year. The second factor is the unifying spirit of innovation in Colorado.
It would have been easier to balance a budget and go home and get ready for the November elections. Instead, the General Assembly plowed ahead and passed more than 20 program improvements and innovations to find better ways to deliver and pay for health care services in Colorado.
Legislators joined forces to pass HB 12-1281, the Medicaid Payment Reform Pilot Program to encourage the development of innovative pilot programs that move away from an inefficient fee-for-service health care system to one that is more cost effective and accountable.
Health Access Pueblo, another innovative health program, was continued in HB 12-1017 through 2017. Health Access Pueblo is a collective effort by employers, employees and the community to provide affordable health services for uninsured, employed adults.
Three bills were passed with the goal of ensuring that individuals in need of long-term services and supports (LTSS) are provided a range of options to find the setting that best meets their preferences and needs. SB 12-127 allows LTSS providers to be designated as “health homes” and to be incorporated into the Medicaid Accountable Care Collaborative (ACC). SB 12-128 creates a Medicaid three-year alternative care facilities pilot program designed to increase the use of alternative care facilities for individuals currently enrolled in a nursing facility who may achieve the same or better outcomes in an alternative care facility.
SB 12-023 requires organizations and staff who enroll individuals eligible for both Medicare and Medicaid services into the ACC to provide information about the Program of All-Inclusive Care for the Elderly (PACE). PACE is a Medicare and Medicaid managed-care program that provides a comprehensive range of health care and support services to frail elderly who are at 55 and older.
Legislators, consumer groups and hospitals worked together to forge a bipartisan compromise that requires hospitals to provide information about financial assistance, payment plans and collection policies to patients and on the hospital websites. SB 12-134 limits the amount low-income patients will be required to pay to the discounted rates that insurance companies pay hospitals.
Colorado initiatives to improve the use of preventive and primary care services require an adequate supply of primary care providers. HB 12-1052 establishes a process to collect data through the state licensure process to create a robust data source to assist in planning for future state health care workforce needs.
A number of measures were passed to improve the efficiency and effectiveness of current state services. For example, HB 12-1054 simplifies the HCPF procurement process for health care providers by reducing the number of different contracts required for each of the health care programs. Additionally, HB 12-1041 creates an electronic death registration system to allow information to be shared more quickly and with less paperwork.
Unfortunately, the session’s bi-partisan spirit broke down on the eve of the last day. One key health bill was caught in the delay. SB 12-108 was an evidence-based initiative to provide oral health services to pregnant women enrolled in Medicaid. The measure had bipartisan support after legislators learned that the strategic use of preventive oral care would ultimately reduce the need for more expensive treatment for women and their young children.
The difficulties in the last days of the session should not detract from the hard work and the successful efforts to create innovative solutions to improve health services in Colorado.