In accordance with federal law, Colorado hired Health Services Advisory Group (HSAG) to do an on-site review of Denver Health Medicaid Choice plan performance in 2013. Denver Health is one of Colorado’s biggest Medicaid contractors. It runs a hospital, a pharmacy, 9 satellite primary care clinics, 4 dental clinics, and 16 school-based health centers. HSAG’s report on Denver Health’s performance was published in April, 2014. All Medicaid clients with a Denver address are automatically enrolled in Denver Health Medicaid Choice unless they choose another Medicaid option.
Denver Health scored well overall. It met 87 percent of all of the evaluative standards. Paperwork on coverage, utilization management, provider certification, and denial of claims documentation was in near perfect order. According to its annual Strategic Access Report, 99.8 percent of Medicaid members were within 30 miles of a Denver Health clinic and there were 54 bus stops within a quarter of a mile of its clinics. It had direct access to care for members with special needs, 24-hour emergency access, preventive health programs, and numerous “committees, workgroups, staff trainings, and evaluation of metrics regarding provision of interpreters and understanding of culture with respect to health care.”