The office of Lieutenant Governor Dianne Primavera has released information on initiatives Colorado is taking with regard to disabilities, various health matters, and healthcare costs. Below are the key components included in Primavera’s information.
Regarding the Rights of Coloradans with Disabilities
A task force on the Rights of Coloradans with Disabilities was initiated by House Bill 23-1296 that was signed into law in 2023. Primavera serves as chair of the task force, which is working to investigate current issues Coloradans with disabilities face and make recommendations to improve inclusivity and accessibility across our state. The task force is part of the Colorado Civil Rights Commission. It will explore a variety of issue areas including modernization of the Colorado Revised Statutes concerning civils rights of persons with disabilities; basic accessibility of outdoor spaces; the affordability, accessibility, and attainability of housing; and basic physical and program accessibility within state and local government. The task force will create subcommittees that will study and make recommendations in each of these areas. It will produce a final report, including recommendations, to submit to the governor and General Assembly on or before January 30, 2025.
Primavera has been featured in public media discussing the importance of making workplaces more inclusive for the approximately 1 in 4 Coloradans living with a disability. “One way we’re investing in people with disabilities is through the Colorado Disability Funding Committee,” she said, “which provides grants to organizations improving outcomes for Coloradans with disabilities.” That Committee has raised some $4 million from the sale of the right to use reserved license plate configurations and historic license plate backgrounds — money that goes toward grant awards. More information on the grant program and specialty license plate program at the Colorado Disability Funding Committee is available on its website by clicking https://disabilityfundingcommittee.colorado.gov/
Office of eHealth Innovation
The Colorado Office of eHealth Innovation (OeHI) is dedicated to improving digital access, health equity, and technology throughout the state. Primavera explains that OeHI is working with the Colorado State Library to fund 23 rural libraries to support more access to virtual services. “Libraries in this pilot can use funding to implement private spaces within their building that patrons can use to have a telehealth or other virtual service appointment,” she says, “so that patients have the connectivity, equipment, and support they might need to have a successful telehealth visit.”
Also in the implementing process is Colorado’s inaugural statewide Social Health Information Exchange (SHIE). Primavera says this is a data sharing network to make it easier for healthcare providers to connect people to the services they need to lead healthy lives — services such as food, transportation, and safe housing. “All roads lead to health,” says Primavera, “and this program helps provide a holistic approach to getting Coloradoans the support they need.” The SHIE team’s work resulted in awarding resources to more than 100 Home and Community Based Services and Behavioral Health providers serving Health First Colorado (the state’s Medicaid program) members to support their digital transformation of patient health records.
Affordability of healthcare in Colorado
Primavera says 2023 brought important firsts for Colorado healthcare. In September, Colorado was chosen as one of nine grantees by the Agency for Healthcare Research and Quality to improve access to care for patients with Long COVID. This was the result of a collaboration between Primavera’s office, the CU Anschutz Medical Campus, National Jewish Health, Family Health West, and Kaiser Permanente. Also involved was the Long COVID Community of Practice Working Group that was formed earlier in 2023 by the Colorado Office of Saving People Money on Health Care team (OSPMHC).
Medical-Financial Partnerships in Colorado
In July of 2023, Colorado’s first Medical-Financial Partnership (MFP) pilot launched in southwest Colorado. Primavera explains that MFPs are “collaborative arrangements made between healthcare providers and community-based organizations that provide a variety of financial services alongside healthcare services aimed at improving financial security for patients and families.” The pilot resulted from state advocacy to address what’s called “financial toxicity.” An earlier report on this illustrated the critical importance of addressing out-of-pocket expenses for patients experiencing chronic illness, which can cause significant financial challenges and emotional distress.
The report explained financial toxicity this way:
Financial toxicity describes the detrimental impacts of health care costs on quality of life, mental and physical health outcomes, and personal finances. It is well documented that individuals with chronic conditions and their caregivers experience disproportionate rates of financial toxicity due to increased direct and indirect costs resulting from seeking and providing care. This can result in financial, physical, and emotional stress, and create a cycle difficult to break. “OSPMHC aims to expand affordable and equitable access to quality care for all Coloradans,” the report stated. “OSPMHC intends to elevate the issue of financial toxicity in order to foster conversation on solutions for the approximately 61.5% of Coloradans living with a chronic disease who may be at risk of experiencing financial toxicity.”
Colorado’s Healthcare-Related Stress
A Colorado fact sheet on healthcare-related stress states that people with chronic conditions and their caregivers have higher health care costs and indirect costs associated with managing chronic disease, and this leads to a higher likelihood of experiencing extreme financial and emotional stress related to health care costs. About 60% of Americans and a slightly higher percentage of Coloradans live with at least one chronic condition, putting many residents at risk for experiencing high costs.
Also, Black, Hispanic/Latinx, Asian, and American Indian/Alaska Native Coloradans experience higher rates of chronic disease coupled with increased rates of individuals living below the federal poverty level compared to White Coloradans. “These conditions exacerbate financial and emotional stressors related to health care costs,” the fact sheet states. “As a result of discriminatory policies and systemic racism, people of color endure disproportionate rates of poor health outcomes and lower socioeconomic status.”
The fact sheet goes on to say that “Disparities across age groups related to healthcare cost and access also impact experiences of financial and emotional stress. For example, while older Coloradans experience higher out-of-pocket costs, younger adults also report difficulty paying for their medical bills. These situations put many Coloradans at risk of extreme impacts from high health care costs.”
In a section titled “Policy Opportunities,” this Colorado fact sheet listed the following:
- Enhance consumer health literacy education through culturally competent outreach.
- Further equitable access to services and resources to allow for cohesive systems of patient support.
- Increase access to quality health insurance to reduce high out-of-pocket expenses.
- Encourage use of a standardized financial toxicity screening tool by providers to identify those at risk for financial stress and tailor treatment plans accordingly.
- Conduct further studies into the causes of extreme stress as a result of health care costs and its effects.
Ideas to Address Financial Toxicity in Colorado
The financial toxicity report mentioned earlier noted that OSPMHC conducted a voluntary survey in Spring 2021 to hear directly from Coloradans on how financial toxicity is present in their lives and work. In doing so, OSPMHC hoped to highlight the real experiences of Coloradans and identify opportunities that stakeholders across the state may explore in order to increase financial security for all Coloradans. Key takeaways included:
● There is a pressing need to address the underlying drivers of high healthcare costs and reduce out-of-pocket expenses for patients, as they impose significant burdens;
● It is incredibly difficult for Coloradans to navigate a complex and inaccessible health care system while managing chronic diseases, with detrimental financial and emotional consequences;
● Residents fail to receive the services and resources they need due to lack of clear communication between health care systems, resource navigators, and service providers and demand for services that far exceeds supply.
The report said stories of Coloradans highlight a variety of opportunities that could further access to care and resources, improve health outcomes, and secure financial stability for residents, including:
● Address affordability by increasing health insurance coverage rates and improving collaboration between financial service organizations and health systems;
● Protect consumers and expand awareness by investing in culturally responsive education and outreach on health care literacy and available services through trusted messengers, protecting consumers from harmful trends in the health care system, and ensuring patients have access to accurate information on providers and services available in their area; and
● Expand access to services and resources by establishing a centralized, comprehensive approach to care coordination as well as social and financial service provision and create and implement a uniform financial toxicity screening tool. OSPMHC said it hopes the accumulated information “will catalyze our community to collectively act to further equitable access to affordable health care and improve the wellbeing of the residents of our state.”