Lifetime Citizen Portal Access — AI Briefings, Alerts & Unlimited Follows
Colorado agency outlines move to outcome-based payments for supported employment, plans July 1, 2026 rollout
Loading...
Summary
Health Care Policy & Financing officials presented a proposed shift from time-based fee-for-service to outcome-based payments for supported employment under the DD and SLS waivers, citing pilot data showing higher employment independence; HCPF said waiver amendments are in public comment and aims to implement July 1, 2026.
The Colorado Department of Health Care Policy & Financing (HCPF) on a stakeholder webinar described plans to replace much of the traditional 15-minute, fee-for-service reimbursement for supported employment with an outcome-based payment model tied to standardized career profiles, job stability and milestone payments. Adam Tucker, who works in HCPF’s Office of Community Living, and Jenny Jordan walked attendees through the rationale, the pilot results and implementation timeline.
HCPF said the change is intended to encourage better job matches, increase provider focus on lasting employment and make supported employment programs more financially sustainable. “What we saw was that the outcomes were better … independence rose, compared at 8% over 12 months as compared to 2.5% for the rest of the waiver population,” HCPF staff reported about their pilot, which HCPF later expanded with ARPA funding.
Why it matters: HCPF told stakeholders that the current unit-based design disincentivizes front-end, intensive work such as career discovery and employer engagement that drive lasting employment. Under the proposed model, job development would be reimbursed when a provider completes a standardized career profile (with optional supplemental modules for members who need deeper assessment), and job coaching reimbursement would be linked to member hours worked during the early phases of employment rather than provider contact time.
Key features described by HCPF include a modular career profile used to document work history, references, transportation and technology needs; three job-coaching phases (day 1–90, day 91–18 months, then maintenance); and milestone incentives. HCPF said milestone payments of $500 would be available to providers when members reach 12 months on the job and again at two years; a third milestone would reward “training with intent,” prioritizing certification of program managers (for example through ACRE or CSP) who can mentor new job coaches.
HCPF emphasized continued interaction with Colorado’s Division of Vocational Rehabilitation (DVR). Presenters said a DVR referral is still required to access supported employment through the DD and SLS waivers, but if DVR places a person on an order-of-selection waiting list the case manager may add job development or job coaching in the person’s service plan and waiver funding can support services while the person waits for DVR capacity.
On provider impacts, HCPF said currently enrolled supported-employment Medicaid providers do not need to re-enroll or apply anew to deliver the model; existing specialties already cover job development, job coaching and workplace assistance. HCPF also said it removed a prior-authorization barrier so nonmedical transportation for employment can be authorized through the service plan even if job coaching or job development is not listed on the PAR.
Timeline and next steps: HCPF described itself as being in a systems-build phase and said the waiver amendments are in public comment; the agency aims to implement the model on July 1, 2026. Individual members will transition at their service-plan meetings after the change goes live; HCPF said it will provide further training for case managers and tools to help determine members’ job-coaching phases.
Questions from attendees focused on tiering for higher support needs, how family providers or informal caregivers fit the model, case manager workload and what providers must do to receive milestone payments. HCPF said rates will be tiered by waiver support level so members with higher needs have access to higher outcome payments, milestone payments are voluntary for providers, and some implementation details (for example an employability vocational assessment) are future work.
The waiver amendments will move next through the public comment record to federal review; HCPF asked stakeholders to submit comment through the public comment process and said it will post the session recording and answers to remaining questions via the EFAP contact list.
