In anticipation of Anthem Blue Cross and Blue Shield and HMO Colorado Inc. (Anthem) open enrollment period this fall, we continue to develop networks to support new product offerings.  We will be offering a new narrow HMO network for the Individual and Small Group market in select counties in the Denver Metro and Boulder market. 


The Pathway Essentials network will be an HMO narrow network, available in the following counties: Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, Clear Creek, Elbert, Gilpin, Jefferson and Park.   Note:  this is a subset of our Pathway HMO network which is still in effect as a statewide network in Colorado.


Our Pathway Essentials network is aligned with the following hospital systems:


  • Boulder Community Hospital
  • HCA
    • Medical Center of Aurora
    • North Suburban Medical Center
    • Presbyterian/St. Luke’s Medical Center
    • Rose Medical Center
    • Sky Ridge Medical Center
    • Swedish Medical Center
    • Spalding Rehabilitation Hospital
  • Rocky Mountain Hospital for Children (HCA)
  • Craig Hospital


Note: The Pathway Essentials network includes all behavioral health, ABA (autism), and ancillary providers (PT/OT/ST, home infusion, home health, DME, lab) in our standard HMO network, unless affiliated with a non-participating hospital system, as well as American Specialty Health (vendor for Chiropractic, Acupuncture, and Registered Dieticians).


Important Distinction:  While “Pathway” is included in the network name, Pathway Essentials is a separate network from our Pathway HMO network.  But, providers participating in the Pathway Essentials network, must also be participating in the Pathway HMO network. 


Anthem sent Amendments in July to those providers that will be participating in the Pathway Essentials network in addition to their continued participation in the Pathway HMO network.  The reimbursement rates for the Pathway Essentials HMO network will be the same as the Pathway HMO reimbursement rates. 


Identifying Members accessing the Pathway Essentials Network:


Three-Character Prefix

Health Benefits Plan Option

Product Type

Network Name

(On Member ID cards)

P4E, X4X



Pathway Essentials


Small Group


Pathway Essentials


Anthem Balance Funding (ABF)


Pathway Essentials


Pathway Essentials sample Member ID card



Provider Webinar opportunities featuring the Pathway Essentials Network


We will be conducting a “Working with Anthem” webinar regarding the Pathway Essentials on Wednesday, October 28, 2020 at 12pm MT.  Please join us to learn about our new Pathway Essentials network and the new products available to access this network starting January 1, 2021.


Webinar Registration link:  Register for a Working with Anthem Webinar.  Webinars are recorded. Even if you are not able to attend on the scheduled date, please register to ensure you receive event recording details once available.


Thank you for the care you provide to our members.




Featured In:
October 2020 Anthem Provider News and Important Updates -- Colorado
October Working with Anthem webinar: Pathway Essentials - Colorado