This newsletter is a snapshot of five things we think are worth knowing something about for senior health care executives and health policy leaders. It’s a quick brief of some of the moving parts of Colorado’s health care sector and policy discussions, with lots of links for you to dig deeper into subjects for more information.
If you already know all of that, thanks for reading our stuff! If you can forward this to a colleague who might want to subscribe, that would be fab!
With help from Michael Goldberg
1. Q&A: Rep. Mark Baisley on telehealth
Rep. Mark Baisley is a freshman Republican Representative for District 39 in Colorado. State of Reform Reporter Haley Donwerth spoke with Rep. Baisley about broadband connections for telehealth in rural Colorado, the downstream impacts from cuts to mental health services, and legislation he plans to focus on next session.
“The laws of supply and demand do not keep up with or create that requirement for bandwidth out to every point in the state, so this is one of those moments where the state government does have an appropriate role to step up and fund extension of broadband out to Colorado for the sake of telehealth. We really need to take advantage of broadband access and delivery of medicine through delivery systems like Amazon and FedEx. Coupled with telehealth, we can really extend the medical care out to every corner of the state, and I think that is a proper role for the Government of Colorado.”
2. Medicaid and the strain of enrollment spike
In 2020 Colorado is projected to see the largest single-year increase in Medicaid enrollees in state history. An estimated 31% of Colorado’s population will rely on Medicaid for health insurance by December 2020, up from 22% in January 2020. According to a new Colorado Health Institute report, this historic surge presents two main challenges for Colorado’s Medicaid system.
Mitigating an influx of backlogged services for Medicaid members is an issue more than 70% of clinicians said they were worried about in a national survey conducted by the Primary Care Collaborative in May 2020. Next, the influx of Medicaid enrollees is expected increase demands on administrative staff to oversee, navigate, and enroll new members. On a positive note, the accelerated release of incentive funds to help primary care practices offset declines in revenue has helped Colorado Community Health Alliance avoid mass layoffs or furloughs, according to staff.
3. Legislature updated on housing insecurity & costs for alternative care sites
Briefing the Legislature on Tuesday, State Budget Director Lauren Larson said that 20% of adults in Colorado report low confidence that they can pay next month’s rent or mortgage on time. One-in-five is a very high number for housing insecurity, according to Larson. Feeding into this concern is Colorado’s ranking as the state with the seventh highest rate of business closures in the U.S.
Providing an update on the costs of setting up alternative care sites for COVID treatment, Kevin Klein, Director of Homeland Security and Emergency Management, said the cost for five statewide sites will be $125 million through the end of the year. Funding from the CARES Act and FEMA will cover the cost of building out of the sites. The state is expected to eat the cost of patient care, however. “We believe that it’s actually more expensive to bill these patients, to set up a billing system, than it is just to eat that portion,” said Klein.
4. Health provisions in HEALS and HEROES Acts
Senate Republicans recently released the HEALS Act – their proposal for the next round of federal COVID-19 relief legislation. House and Senate leaders, along with representatives from the Trump administration, must now reconcile it with the HEROES Act, which House Democrats passed in May.
In his latest column, our DC-based State of Reform columnist Jim Capretta breaks down the differences in the health-related provisions of the two proposals. He highlights differences in testing and contact tracing funding, health care provider financial support, vaccine development and distribution, and support for job-based health insurance. “The U.S. squandered the beneficial effects of the March-April lockdown on a flawed reopening in May and June,” he writes. “The bill Congress is now negotiating is critical to setting the country on a better course to weather the pandemic over the coming months.”
5. Colorado, Washington, Nevada and Oregon announce coordination on telehealth
Gov. Polis joined Washington Gov. Jay Inslee, Nevada Gov. Steve Sisolak and Oregon Gov. Kate Brown to announce that their states will be working together on telehealth issues. In a joint statement, the governors outlined seven overarching principles that will guide the coordination effort: Access, Confidentiality, Equity, Standard of Care, Stewardship, Patient choice, and Payment/reimbursement.
In their statement, the governor’s made no bones about which direction they see the wind blowing: “Telehealth is here to stay,” they said. Between April and June, federally qualified health centers billed Medicaid $12,649,670, which was the highest amount billed by a provider type according to state data.