Source: Denver Business Journal
Facing new challenges is old hat for Colorado health care providers large and small.
A major change to federal and state funding for Medicaid, which pays for about a quarter of all health care services received by Coloradans, is the latest in a string of obstacles that threaten financial and operational sustainability for many hospitals.
Market leaders among Colorado’s health care providers, representing HCA HealthOne, Children’s Hospital Colorado, Kaiser Permanente Colorado and Boulder Community Health, sat down with the Denver Business Journal on Aug. 27 to discuss how their organizations are staying competitive in such a landscape — and what’s in store for the months and years ahead.
Financial pressures
For Robert Vissers, president and CEO of Boulder Community Health, simply navigating the “tremendous” amount of change and uncertainty in health care for the next one to three years is enough of a goal, although Vissers said it’s a familiar one.
“If I didn’t sleep every time there was either a present or pending health care crisis, I would not have slept since 2019,” Vissers quipped.
But a reduction in Medicaid funding — particularly in Colorado, which often ranks among the lowest in the nation for reimbursement — could result in health care facilities cutting not just operational fluff, but foundational services, Vissers said. Fewer people on Medicaid translates to fewer people insured in Colorado, which removes compensation for health care services and often results in higher acuity care because those people have been deferring doctor’s visits, Vissers said.
Medicaid redetermination since 2023 has already resulted in the same kind of problem, said Chad Christianson, president and CEO of HCA HealthOne. The process has involved reevaluating and removing tens of thousands of Coloradans who were kept enrolled in the program during a pandemic mandate.
“A lot of [patients] showed up into our emergency departments believing they had Medicaid, only to find out from us that they did not have Medicaid,” Christianson said.
That left HealthOne, he said, challenged with balancing the cost of health care innovations and future investments with the need to fill financial gaps left by uncompensated care.
Jena Hausmann, CEO and president of Children’s Hospital Colorado, echoed those concerns. Children’s loses about $382 million per year to take care of Medicaid patients due to a gap in reimbursement, so any further reduction in funding could result in dramatic outcomes, she said.
“The status quo will not be able to be maintained with the level of access to services that we have been accustomed to,” Hausmann said.
Mike Ramseier, president of Kaiser Permanente Colorado, said that changes to funding for insurers also threaten to destabilize some aspects of business. Although state lawmakers in their special session in August passed a law that will help fund an anticipated drop in reinsurance at the federal level, Ramseier said he expects to see a high level of churn in insurance regardless.
Ramseier forecast that the funding pressures could also affect negotiations between health systems and insurers, which have already shown signs of high tensions in the past year.
What’s next
Ramseier was the sole panelist who said his organization is in the process of building, renovating or opening new clinic locations in Colorado.
“This is, I think, the first time in 15 years that we’re actually adding bricks and mortar,” Ramseier said. “We’re expecting to actually grow starting next year based on all the fundamental [work] we’ve done.”
Hausmann said that Children’s has been focused on growing its technology, home health care capabilities and other alternatives to more expensive acute care facilities.
Christianson said that HCA HealthOne, which also includes locations in Kansas, has focused on growing outpatient access. The system has 294 outpatient centers and is continuing to expand, he said.
