Better Solutions for Healthcare

Denver Business Journal: Finally, transparency in Colorado healthcare pricing takes major step forward

Finally, transparency in Colorado healthcare pricing takes major step forward

Denver Business Journal
July 26, 2018

On July 16, the organization rolled out its most comprehensive comparison
tool yet.

After years of struggles to collect and disseminate the health-care pricing data
it long intended to get into the hands of the public, the Center for Improving
Value in Health Care has turned a corner and has begun to fulfill its
expectations of giving consumers more knowledge of the difference between
the costs of services across the state of Colorado.

On July 16, the nine-year-old nonprofit with responsibility for maintaining
Colorado’s All Payer Claims Database released its most thorough cost-
comparison tool yet: a listing of the prices of 13 common imaging services at
facilities throughout the state. Publicly available on its website, the tool
showed price variances of as much as $7,990 for an abdominal CT and rolled
out the costs at specific hospitals and imaging centers, in order to let
consumers know just what they could pay if they are not getting any insurer-
negotiated discounts.

The new tool marked a significant increase in CIVHC’s capabilities from just
six years ago, when the organization — viewed as one of the key tools to
slowing health-care cost inflation — received information from only the eight
largest private insurers in the state and struggled to collect data particularly
from large, self-insured employers that held the greatest leverage with health-
care providers. Even as recently as June 2017, as CIVHC dramatically
ramped up its data troves, it had an inability to display its findings in an
understandable way and went a full year without updating publicly available
information because of a dispute with its former vendor for its website.

Cari Frank, vice president of communication and marketing, said CIVHC plans
to do more, rolling out tools to let users compare common types of outpatient
surgery or to see how hospitals stack up against each other both on cost and
quality. Eventually, the services of private physicians’ offices should be in the
database too, she said.

But the launch of the imaging comparison was meant to serve as a notice that
consumers who are willing to take the time to shop for health services like

they would shop for plane tickets or consumer electronics can now find
information that can ensure they are not shocked when they get the bill after
an operation.

“I want them to know that they need to shop for care and that it’s important to
do that, even if you have 100 percent coverage,” Frank said. “People need to
know there’s such a price discrepancy, depending on where you go … I am
hopeful hospitals will also take note.”

The idea for CIVHC first sprang from former Gov. Bill Ritter’s Blue Ribbon
Commission on Health Care that made recommendations on how to increase
access and control costs in 2008 — two years before the passage of the
federal Affordable Care Act attempted to take on the same aims. In 2010, the
Colorado Department of Health Care Policy and Financing appointed the
recently constituted CIVHC as the administrator of the APCD, a legislatively
created tool to compel insurers and providers to make information on their
costs and payments available for public inspection.

[ Read More … ]