The State of the State of Colorado

State of the State of Colorado, the Centennial State

In this series, MediSked experts explain the latest transitions in the home and community-based services industry and what’s to come in the future of each state.

Today’s state

Colorado is currently working off the last approved 1915 (c) waiver, expiring in 2024. The department of Healthcare Policy & Financing, also known as HCPF (pronounced hic-puff), holds administrative contractual agreements with 20 non-state, private, non-profit corporations called Community Centered Boards (CCBs) to act as the single-entry point agencies to perform Home and Community Based (HCBS) waiver operational and administrative services including intake, verification of target criteria, completion of the level of care assessment, enrollment, utilization review, and quality assurance.

These agencies also operate as Organized Health Care Delivery Systems and contract with other service providers for the provision of services under this HCBS waiver. These local nongovernmental non-state entities also provide Targeted Case Management and waiver services through Medicaid Provider Agreements.

The average per year/per person cost is $74,395.31 with 8,812 individuals on the waiver. The average length of stay on the waiver is 338 days.

What’s next

HCPF is embarking on an ambitious project to completely redesign its care management system. In an effort to provide conflict-free case management and overhaul a dated system, HCPF has brought together providers and stakeholders alike, to put collective minds towards achieving their goal. They have set out this timeline below:

The first step was determining catchment areas where services would be provided in each geographic region of Colorado. This was a multi-step process that involved public surveys and a stakeholder team to ensure that all Coloradans were covered in this modern design.

The next step in their process will be determining the rates for billing of case management services as well as the standards each of the potential new entities will be beholden to. They have a quality management survey which will be used to gather feedback from stakeholders before any decisions are to be made.

Colorado is not near the end of their road as they will not be seeking a proposal until winter of 2022, if the timeline remains the same. They are a state to watch as their approach to this redesign has been transparent and honest with all stakeholders involved.

The last thing to note about Colorado is that they are under a deadline, as their extension of the federally mandated Conflict-Free Case Management Rule ends in July of 2024. Three years may seem long, but a project of this size will need every minute they can get.

What the state will need

As Colorado transitions to its new case management system, it will need a software solution to handle all of the state’s data, report on outcomes, and gain insights into how case managers can improve the lives of the individuals they support. Colorado can support care management activities and amplify oversight with MediSked’s robust reporting and business intelligence tools. The MediSked Solution Suite is configurable, interoperable, and supports a modular health IT stack to promote cost savings and efficiency. Learn more about our solutions for government and oversight agencies here!

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Evan Christenson, Esq.

Evan Christenson, Esq., a Compliance Policy Analyst, joined MediSked in 2021, and is a licensed attorney with an educational background in Business Intelligence. Evan’s primary focus is industry research and maintaining regulatory compliance with state and federal laws such as HIPAA and HITECH, as well as analyzing, drafting, and implementing new policies to ensure MediSked’s continued compliance for the clients we serve.

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