217C52623E66CE8E87258360005BDDF7 Hearing Summary

Kim Bimestefer, Executive Director, HCPF, presented on HCPF's long term goals and distributed a packet of information to the committee (Attachment D).  Tom Massey, Deputy Executive Director, HCPF, provided data on enrollment and eligibility requirements for Medicaid and the Child Health Plan Plus to the committee.  

 

 

 

 

Bonnie Silva, Office of Community Living Interim Director, HCPF, described HCPF's long term services and supports programs and the recipients of these programs.  She explained that these supports can be provided at home, in the community, or in facilities, and described the different payers for the services.  Ms. Bimestefer responded to questions regarding the Program for All-inclusive Care for the Elderly, service provider rates, and eligibility requirements for child heath programs.

Director Bimestefer discussed HCPF's goals, including rural hospital sustainability, reducing the uninsured rate, and providing substance use disorder treatment.  She also discussed challenges, including the rising federal deficit and the rising cost of care.  Ms. Bimestefer provided demographic and enrollment data for Health First Colorado, and discussed major program expenditures.

Dr. Tamaan Osbourne-Roberts, Chief Medical Officer, HCPF, described the top categories of care for Health First Colorado clients to the committee and noted that many clients have more than one medical condition.  Ms. Bimestefer described HCPF's performance plan strategic policy initiatives.  She discussed progress with Senate Bill 18-266, which authorized technological innovations that will help HCPF to compete with private insurers.  The bill also created a cost control and quality improvement office in HCPF.

Stephanie Ziegler, Cost Control and Quality Improvement Office Director, HCPF, described the provisions of Senate Bill 18-266 that will allow HCPF to implement programs to improve quality and control costs.  Laurel Karabatsos, Interim Medicaid Director, HCPF, updated the committee on progress with the Accountable Care Collaborative (ACC), which coordinates care regionally and utilizes data to make certain medical decisions.  She described Phase II ACC objectives, including integrating physical and behavioral health care under Regional Accountable Entities and strengthening the coordination of care.

Cathy Traugott, Pharmacy Manager, HCPF, gave an overview of the pharmacy benefit for the Colorado Medicaid program, including spending on specialty drugs.  She described HCPF initiatives to control drug costs including implementation of a new claims system and utilizing a preferred drug list and supplemental rebates.  Ms. Traugott explained HCPF's policy to reduce opioid prescriptions and the number of pills distributed to Medicaid clients. She responded to questions about medically necessary prescribed drugs and chronic pain patients.

Director Bimestefer described efforts to drive down health care costs for employers, consumers, and the Medicaid program.  Efforts include controlling hospital and prescription costs, implementing alternative and innovative payment methods, and focusing on population behavioral health.

Chris Underwood, Health Information Office Director, HCPF, described customer service improvements to the PEAK eligibility and application system.  He described HCPF's regional field representatives that assist Medicaid providers.  Mr. Massey explained HCPF's legislative agenda, including extending the breast and cervical cancer prevention and treatment program, increasing access to the low income senior dental program, and increasing oversight of host homes.

Mr. Massey summarized HCPF's budget requests and the regulatory agenda for 2019.  He provided an update on House Bill 18-1321 regarding urgent non-emergent medical transportation, and Senate Bill 17-121 regarding improving Medicaid client correspondence.  Mr. Massey highlighted HCPF's legislator resource center.  

Mr. Massey, Mr. Underwood, and Ms. Silva responded to committee questions.