Colorado
Polis’ budget proposal would cut Colorado support for training new doctors
Gov. Jared Polis’ administration is proposing an $18.2 million cut to Colorado’s funding for medical education, a reduction that hospitals say might force them to reduce training slots.
The cut applies to residency programs, which train medical school graduates for three to seven years before they move into independent practice. Medicare funds direct costs, such as residents’ salaries, for the majority of available slots.
States can then choose whether to use Medicaid — whose costs they split with the federal government — to fund indirect costs and additional slots. Currently, Colorado is one of 23 states that do, according to Polis’ Jan. 2 budget letter.
The Department of Health Care Policy and Financing, which administers the funding, didn’t clarify Monday whether the cut would end the state’s contribution to indirect medical education costs, or if it would continue to provide a smaller amount.
“Reductions in (indirect medical education) payments would be limited to system hospitals, those more able to lean on their systems partners to share financial burden; no rural hospitals would be affected by this policy,” the letter said.
Hospitals also can bill patients’ insurance for services provided by residents, though not for the time that established doctors spend supervising them.
The state faces a challenging budget year, with a shortfall of nearly $1 billion. The governor’s budget proposal, which includes significant cuts to Medicaid beyond reducing spending on medical education, got a less-than-enthusiastic reception from lawmakers when he presented it in November, though.
The American Association of Medical Colleges reported 21 hospitals in Colorado participate in teaching. More than one-quarter of the 1,220 residency slots in the state don’t receive funding for direct costs from Medicare, making indirect cost funding important to maintaining them, it said in a fact sheet.
The $18.2 million cut to medical education at facilities that are part of systems would cost teaching hospitals an additional $41.5 million in federal matching funds, said Heather Retzko, one of the principals at Policy Matters, a lobbying group that works with the hospital industry in Colorado. At this point, the department hasn’t clarified if all 17 teaching hospitals that are part of systems would face equal reductions, she said.
Dr. Richard Zane, chief medical and innovation officer at UCHealth, said the system has “hundreds” of residency slots that don’t receive funding from Medicare, meaning that if state funding disappeared, it would have to either come up with the money itself or cut those positions. He declined to speculate about how many training slots it might eliminate.
“It would be substantive. That’s all I can say,” he said.
Nationwide, an average of 60% of doctors ultimately practice in the market where they completed residency, so fewer slots in Colorado would mean fewer health care providers here in the future, Zane said. The step seems counterproductive, since one of the arguments behind opening a new medical school at the University of Northern Colorado was that the state needs more doctors, he said.
“Despite adding medical student positions, we’re decreasing training positions,” he said.
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South Broadway’s newest bar in Denver is a “nostalgic-forward neighborhood cocktail bar” called the Good Luck Club. However, it’s been anything but lucky.
“It would have been really helpful to have a road map of here’s how you open up a bar,” said Ben Hamilton, Good Luck Club’s general manager. “Here are the steps you need to take.”
It’s finally open, six months behind target, thanks to a guessing game they didn’t know they were playing.
“I was like jumping over hurdles and navigating a maze to try to figure out and put all the pieces of the puzzle together,” Hamilton added. “There was a good list of complications that we ran into when we were filing for our liquor licenses, our zoning permits, our assembly permits.”
However, the city knows about the problems behind the permit process.
Tuesday marks exactly one year since Denver Mayor Mike Johnston signed his first executive order overhauling the city’s permit process with a new office.
“It’s really hard for our customers to understand what is needed for every type of construction project that could be out there,” said Robert Peek, the director of development systems performance with the Denver Permitting Office.
Hamilton says that was exactly what he and his team faced: “It seemed like it was never the full answer.”
That’s why the Denver City Council approved a $4.6 million contract with ComplyAI for a tool that will help streamline and speed up the process.
“It’ll do an initial review of their applications and their plans and identify anything that I’m missing or anything that is approvable for the city,” Peek said.
The software could shave weeks off the process, and hopefully, in the future, businesses like the Good Luck Club can serve the community more quickly.
“We see this as part of our larger effort to really revitalize our local economy by getting these businesses and homeowners to move into their homes,” Peek said.
The permitting office is just beginning the implementation process to integrate the artificial intelligence tool into the system. They hope to launch it to the public by the end of the year.
Meanwhile, the Good Luck Club is having its grand opening on April 30.
The Colorado Avalanche’s head coach will not travel with the team this week due to injuries he sustained after being hit with a puck during a game over the weekend.
Jared Bednar will stay at home as the team travels for two of its last regular season games in Canada, according to a statement from the team. Bednar was diagnosed with facial fractures and a corneal abrasion, but is expected to make a full recovery without surgery.
During Saturday night’s game against the Vegas Golden Knights, a stray puck hit by the Knights’ Keegan Kolesar went over the boards and into the Avalanche’s bench. Bednar was struck on the right side of his face and taken to the hospital to be evaluated.
The assistant coaching staff, which includes Dave Hakstol and Nolan Pratt, took over after Bednar left the game. Pratt told reporters in the postgame press conference that the hit was “unnerving.”
“It’s scary when the pucks are flying in there, it happens all the time,” Pratt said, adding that it was “unfortunate tonight.”
But the team recalibrated and returned to play, Pratt said.
The Avalanche lost in overtime, but have already secured their playoff spot.
Pratt and Hakstol will lead the Avalanche in the Monday night game against the Edmonton Oilers and Tuesday’s game against the Calgary Flames. The team will return to Denver’s Ball Arena for its final home game before playoffs on Thursday.
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