This week, Governor Polis, Lt. Governor Primavera, and the Department of Health Care Policy & Financing (HCPF) announced the Hospital Price Transparency Tool,which allows employers, municipalities, consumers, advocates, policymakers, other health care payers and state regulators to compare the costs of more than 5,000 procedures at 82 Colorado hospitals.
This tool compares multiple hospitals’ gross charges, cash discounted prices, estimated Medicare costs, and commercially negotiated prices, building on Colorado’s nation-leading hospital affordability work intended to save people money on healthcare.
“Saving Coloradans money on healthcare will keep more hard-earned money in people’s pockets, improve our quality of life, and make our state more affordable for everyone,” said Governor Polis. “This transparency tool is another way Coloradans, employers, and leaders can ensure Colorado’s competitive healthcare market provides high-quality care at low costs. This builds on our work to make healthcare, including prescription drugs, insurance premiums, and more, cheaper for everyone.”
This free tool displays 2.5 million commercially negotiated prices for over 5,000 procedures provided by 82 Colorado hospitals. The tool allows purchasers and consumers to compare multiple hospitals’ gross charges, cash discounted prices, Medicare costs, and commercially negotiated prices (contracted reimbursement rates) for each insurance carrier’s network product or plan.
“Hospital costs make up the largest part of health care premiums and health care benefit costs. By lowering hospital prices, you lower premiums and benefit costs,”said HCPF Executive Director Kim Bimestefer. “Every community can leverage this tool to see if its local hospital is charging its residents and businesses higher prices than other Colorado hospitals for the same services. Knowledge is power, and this tool empowers community leaders to have productive affordability conversations with their hospital’s executive team intended to lower their prices to the benefit of all those in that community.”
On January 1, 2021, the Federal Price Transparency Rule went into effect, requiring hospitals to publicly post five standard charges: gross charges, discounted cash prices, de-identified minimum and maximum rates, and payer-specific negotiated rates, for all items and services, in a machine-readable downloadable file. Leveraging this information, this Colorado-specific price comparison tool provides easy-to-access comparison information on the state’s hospital prices, to the betterment of health care costs paid by consumers, employers, municipalities, and other purchasing groups.
Uses for the Tool
- The tool will be a valuable resource for employers, municipalities, chambers and other
negotiators working to lower health care costs, as it enables extensive price comparisons and
productive affordability conversations with community hospitals. - Self-pay individuals can use the tool to identify hospitals with lower discounted cash prices for a
specific procedure. Since this tool will be updated twice a year, self-pay individuals should visit
hospital websites for single procedure comparisons to make their final decisions. - This tool also enables consumers and employers to hold insurance companies more accountable
for the prices they negotiate with hospitals and to help inform which carriers and network
products (sometimes called plans) that they ultimately choose to purchase. - Legislators and other policymakers can leverage the tool to frame emerging and impactful
affordability policies. - Lastly, independent researchers and organizations can use this tool to analyze variations in
hospital-posted prices.
This new Hospital Price Transparency Tool along with HCPF’s previously released reports and tools are intended to help lower health care costs that save Coloradans and our employers money on health care.
The landmark Colorado Option and Reinsurance efforts continue to save Coloradans millions each year on healthcare. Through Colorado’s Prescription Drug Affordability Board, its rebate pass-through, spread pricing prohibitions, and innovative prescriber tools, the state is becoming a national model to help lower the cost of prescription drugs.
Visit HCPF’s Hospital Reports Hub to view this year’s pricing transparency reports, along with previous HCPF hospital reports and other resources.
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