Benefits Collaborative

Please read this IMPORTANT UPDATE to the Benefits Collaborative Process

View Approved Benefit Coverage Standards

Benefits Collaborative Background

Health First Colorado (Colorado's Medicaid Program) established the Benefits Collaborative in 2008, in an effort to define its covered services. The Benefits Collaborative serves as the Department's formal coverage standard development process. The Benefits Collaborative process ensures that benefit coverage standards:

  • Are based on the best available clinical evidence and best practices;
  • Outline the appropriate amount, scope and duration of Health First Colorado services;
  • Are cost effective and set reasonable limits upon those services; and
  • Promote the health and functioning of Health First Colorado members.

Description

By looking to nationally accepted clinical guidelines, Health First Colorado's benefit coverage standards align with national practice guidelines and promote standards of care and appropriate utilization.

Since the Benefits Collaborative aims to produce evidence-based policies guided by best practices, we seek to invite a diverse group of stakeholders - providers, administrators, members, advocates, policy makers, etc. into the process. There has been a dedicated commitment to:

  • Identifying all possible stakeholders with an interest in helping Health First Colorado shape its coverage standards; and
  • Transparent communication

The Benefits Collaborative is a process, not just a collaborative stakeholder meeting or series of meetings. The process begins with the drafting of a benefit coverage standard and ends when the final draft is taken to the Medical Services Board (MSB) and is approved for incorporation into Health First Colorado rules. The full process is illustrated below.

Details

For additional information regarding the Benefits Collaborative, please contact:

Kimberley Smith
1570 Grant Street
Denver, CO 80203
(303) 866-3977