Happy midday to you, Colorado, and welcome to another edition of The Temperature, the only newsletter on climate and health bold enough to ask the question: How ’bout this wild weather, amirite?
We’ve been spending a fair amount of space in these intros teasing the Colorado Rockies, so maybe we change it up and tease another local sports team — like, say, the Denver Nuggets, whose head honcho out of the blue recently mentioned the possibility of trading away the greatest player/oversized hobbit in franchise history. The sports bros are not happy!
For context, this would be like me saying this newsletter may have to trade Michael Booth for cash to sustain our well-established quest to bring back the Choco Taco. It would be a horrible idea. (But, also, you know, make us an offer!)
What’s not a horrible idea is getting caught up on your local news. Let’s do that right now.
Reporter
TEMP CHECK
HOSPITAL FINANCE
UCHealth wins first round with state over hospital provider fee money
$50 million
The potential annual amount at stake in a fight between UCHealth and Colorado officials
UCHealth has prevailed for now in an exceptionally complicated fight with the state Medicaid agency over hospital provider fee money — a dispute that could see as much as $50 million a year shift away from public hospitals and move to private hospitals, according to state officials.
The fight has to do with whether two UCHealth hospitals that once were public, Poudre Valley Hospital in Fort Collins and Memorial Hospital in Colorado Springs, should still be considered public. UCHealth, a private nonprofit, has for years managed the hospitals under its banner pursuant to long-term lease agreements.
But the Colorado Department of Health Care Policy and Financing continued to classify the two hospitals as public for the purposes of the hospital provider fee — a mechanism the state uses to draw down a boatload of federal money, much of which it sends back to hospitals.
Under the system, hospitals pay a fee based on their amounts of inpatient and outpatient care. The state combines that pool of money with the matching federal funds and then redistributes it, focusing especially on helping hospitals that treat a lot of Medicaid patients.
The result is that the hospital system, as a whole, comes out ahead, as do the vast majority of individual hospitals. (See the Chart of the Week below for more on this.)
In the most recent fiscal year, Colorado hospitals paid roughly $1.3 billion in fees and got back about $1.8 billion in payments, netting the industry a $500 million win. But some hospitals end up getting back less than they put in.
How this reallocation works depends in part on how a hospital is categorized — whether it is grouped with state government-owned hospitals, private hospitals or other public hospitals. The state had classified Poudre and Memorial as “non-state government owned,” but UCHealth disagreed and sued in state court to reclassify the hospitals as private.
Last month, a district court judge in Denver agreed, writing, “Because the court holds the hospitals are the sole owners and operators of Memorial and PVH (Poudre Valley Hospital), the court also holds Memorial and PVH were incorrectly categorized.”
The lawsuit focused narrowly on technical arguments about federal law and rules. But the context is this: Both Memorial and Poudre don’t currently get a lot back from the provider fee system. Last fiscal year, Memorial netted less than $1 million and Poudre lost more than $12 million.
UCHealth spokesperson Kelli Christensen wrote in an email that recategorizing the hospitals “could result in higher payments,” but she added that it’s not certain, given the complexities of the system.
UCHealth, the state’s largest health care provider, is also its largest provider of services to Medicaid patients, and Memorial and Poudre treat more Medicaid patients than any other hospital in their respective regions, Christensen noted.
“Following federal law and correctly classifying hospitals is important to ensure proper payments to hospitals that care for Medicaid patients,” she wrote. “An incorrect classification can result in underpayments — and this hurts both the hospital and Medicaid patients.”
But state officials say the court ruling could hurt other hospitals that treat a lot of Medicaid patients, namely the others categorized as non-state government owned public hospitals. This list includes Denver Health and a slew of small, rural hospitals operated by local hospital districts.
Nancy Dolson, the special financing division director for the Department of Health Care Policy and Financing, said pulling Memorial’s and Poudre’s contributions out of that pool and moving them over to the pool for private hospitals could shift $25 million to $50 million annually away from publicly owned hospitals.
“We need to really recognize the impact and harm that, in some circumstances, could be more-than-significant to our rural hospitals and Denver Health if this decision would prevail,” Kim Bimestefer, the executive director of the Department of Health Care Policy and Financing, said in an interview.
The state is considering whether to appeal the judge’s ruling.
Section by John Ingold | Reporter
VACCINATION
Why does Colorado have so many breakthrough measles cases? Blame math.
Two shots of the MMR vaccine give an individual a 97% chance of avoiding a measles infection when exposed.
And, though the math really shouldn’t work out this cleanly, that number has a near-echo in the most recent measles outbreaks nationwide — 95% of the people infected have been unvaccinated or had an unknown vaccination status, according to the federal Centers for Disease Control and Prevention.
But, in Colorado, six out of 16 infections have been in people who are fully vaccinated. That’s more than a third.
So, what gives? Does the vaccine work worse at altitude or something?
No, said a bunch of experts The Sun spoke with.
“I wouldn’t want people to get discouraged,” said Dr. Michelle Barron, the senior medical director of infection prevention and control at UCHealth University of Colorado Hospital.
Instead, the experts offered up some possible explanations for why a higher percentage of vaccinated people in Colorado have been infected:
1. We’re looking at small sample sizes.
Numbers can do squirrelly things when examined in small amounts!
2. More than half our cases are tied to an airport superspreader event.
Being crammed close to an infectious person for long periods may increase the chance that a vaccinated person gets sick. Four of our vaccine breakthrough cases were linked to the Turkish Airlines incident, and the two others were also linked to international travel.
Barron said she’s always astonished at how crammed DIA is — on the train, around the gates and in line at the stores. That’s why she wears a mask at the airport.
“You’re literally up against everybody,” she said.
3. Colorado may be better at detecting infections.
Dr. Daniel Pastula, a professor of neurology, infectious diseases and epidemiology at the Colorado School of Public Health and the University of Colorado School of Medicine, said Colorado has a robust public health system compared to other states. And he said doctors and other medical providers are on alert for measles cases.
“We are more likely to catch mild cases that other states may miss,” he said.
4. When a lot of people are vaccinated, the math can counterintuitively work against you.
If 10 unvaccinated people are exposed to measles, the conventional thinking is that nine will likely get sick. That’s a really high infection rate. And, as we mentioned before, if 100 vaccinated people are exposed to measles, only three will likely get sick.
But here’s the mathematical mind-bender: If the total number of unvaccinated people is small compared with the number of vaccinated, then the total number of vaccinated people who get infected may actually end up higher than the number of unvaccinated people who do.
We’ve been working on some fun graphics to illustrate this. Watch ColoradoSun.com in the coming days for that story.
Section by John Ingold | Reporter
INFECTIONS
Tracking Colorado’s stealth 16th measles case in 2025
9
The number of Colorado measles cases tied to an infectious traveler at DIA
The number above was not a typo; Colorado recorded its 16th measles case of the year last week.
You may not have noticed — I certainly didn’t at first. The state put out no announcement of the case. It was only when I was pulling data for the above item that I saw there was an extra case reported in the state’s tally for 2025.
Here’s the story: The newly reported case was in an adult from Arapahoe County who was likely exposed at Denver International Airport during the time an infectious traveler was passing through. This now makes nine Coloradans who were infected by the traveler, either on the Turkish Airlines flight into DIA or inside the airport.
The 16th case was unvaccinated and was hospitalized, though no additional information is available about how they’re doing. So far this year, four people have been hospitalized with measles, and there have been no known deaths from the disease.
Hope Shuler, a spokesperson for the Colorado Department of Public Health and Environment, wrote in an email that, “We did not do a public announcement because we were outside the window where anyone who came in contact with this person would have developed symptoms.”
In other words, if the point of announcing each new measles case is to let people know they may have been exposed and could soon get sick, that ship had sailed in this instance.
But the newly added case does show that measles remains sporadically out and about in Colorado — not in a big way, and there is still no evidence of transmission locally. But just something to keep in the public health cranny of your brain.
Section by John Ingold | Reporter
MORE ENVIRONMENT AND HEALTH NEWS
CHART OF THE WEEK
Up above, we talked about the hospital provider fee. This chart shows which hospitals benefit the most from it.
Of the 85 acute care hospitals listed in the most recent annual report for the Colorado Healthcare Affordability and Sustainability Enterprise — the entity within the Department of Health Care Policy and Financing that collects and redistributes the fees — 67 received a net benefit last year.
The biggest beneficiaries were also some of the state’s biggest providers of services to Medicaid members — Denver Health and UCHealth University of Colorado Hospital. At the other end, there were 18 hospitals that received back less than they put into the system, with HCA HealthONE Sky Ridge at the bottom. The hospital paid in $24 million more than it got back.
You can see the complete list in Appendix A of the enterprise’s annual report.
The hospital provider fee could be up for big changes at the federal level. A proposal in the U.S. Senate, part of the Senate’s under-construction version of the giant tax and spending bill, would cap how much states can charge in provider fees, thus also limiting how much matching federal dollars they could draw down.
In the first year of the Senate proposal, the state estimates it would see $115 million less collected in provider fees and a subsequent $180 million hit to what it gets in federal funds. By the time the full weight of the Senate proposal is in effect in 2030, Colorado estimates it could see an annual loss of more than $550 million in provider fees collected and as much as a $2.5 billion hit to federal funding.
Section by John Ingold | Reporter
Woo, that was a long one. Has enough time lapsed for the return of the Choco Taco? No?!? Perhaps we should look more closely into what a Michael Booth goes for these days …
We promise, though, that we’ll never abandon you amid a sugar crash. We think your support of local journalism is already really sweet.
Till next week, when your groan at the previous sentence may have finally ended.
— John & Michael
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Corrections & Clarifications
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