Sector 路 Healthcare

Healthcare decisions are too consequential for managed opposition.

Healthcare policy decisions involve some of the most complex stakeholder dynamics in state government: agencies managing unsustainable cost trends, advocates protecting access for vulnerable populations, providers with competing interests, and communities whose needs are rarely captured in administrative data. Confluence has designed processes for this landscape that produce genuine engagement rather than performative input.

Active

LTSS Work Group, 18-month process through September 2027

HCPF

Medicaid sustainability engagement informing departmental planning

2027

Final LTSS recommendations to Governor and legislature

Stakeholder Engagement 路 Medicaid 路 Healthcare Policy

HCPF Medicaid Innovation, Sustainability & Opportunities (MISO)

HCPF Medicaid stakeholder engagement
Colorado’s Department of Health Care Policy and Financing faced a challenge common to state Medicaid agencies: the need to make difficult decisions about a system that affects hundreds of thousands of people, with a stakeholder landscape where large public engagement processes typically generate more adversarial noise than usable input.
Confluence designed and managed a sequenced multi-phase engagement process that moved a large and diverse stakeholder audience from shared context through policy education to focused small-group input. The architecture was deliberate: establishing a common factual foundation before surfacing perspectives, and creating structured small-group formats that allowed participants to engage substantively rather than reactively.
The process produced input that directly informed the department’s Medicaid sustainability planning and demonstrated that a complex, politically charged policy process could generate honest stakeholder engagement rather than managed opposition.
Client
Colorado Department of Health Care Policy and Financing
Method
Sequenced multi-phase engagement 路 Shared context first 路 Structured small-group input
Output
Input directly informing HCPF Medicaid sustainability planning

Multi-Stakeholder Coalition 路 LTSS 路 Disability Rights

Colorado LTSS Work Group

LTSS Work Group
Colorado’s Long-Term Services and Supports programs help people with disabilities and older adults live independently in their homes and communities. Those programs are under serious pressure. Costs have risen steadily for years. People who rely on the services report growing complexity and frustration. And decisions about the system’s future have too often been driven by short-term budget pressures rather than a clear-eyed understanding of what the system needs.
In 2026, the Colorado Cross-Disability Coalition and the Colorado Health Foundation retained Confluence to design and facilitate an 18-month multi-stakeholder process to change that. The LTSS Work Group brings together people with lived experience, subject matter experts, advocates, providers, and policymakers to examine the full scope of Colorado’s LTSS system and develop concrete recommendations for structural change.
A Steering Committee of 15 to 20 members guides the overall direction of the work and oversees up to four expert subcommittees. The process runs through September 2027. Final recommendations will be delivered to the Governor, the Joint Budget Committee, and legislative health committees.
Active

18-month process running through September 2027.聽

More information at LTSS Work Group

Clients
Colorado Cross-Disability Coalition 路 Colorado Health Foundation
Scope
Steering Committee 路 Up to four expert subcommittees
Deliverable
Recommendations to Governor, Joint Budget Committee, and legislative health committees

The process demonstrated that a complex, politically charged policy engagement
could generate honest stakeholder input rather than managed opposition.

HCPF MISO Stakeholder Engagement 路 Colorado

The conversation starts
here.

State agency leaders, Governor鈥檚 offices, county governments, and organizations navigating problems that have resisted every standard approach reach out directly. The engagement starts with a conversation.

General Inquiries

inquiry@confluencepsg.com

Colorado

303.551.6989

North Carolina

910.239.8740

Geographic Reach

CO 路 NC 路 FL 路 National