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CIVHC Release: Medicare Reference-Based Price Analysis

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A newly-released CIVHC analysis comparing commercial health insurance payments to Medicare payments reveals wide variation across Colorado hospitals, and average payments outpacing national averages. Colorado’s highest payed hospital receive more than five times Medicare rates (508%) for inpatient and outpatient services combined, while the hospital at the lowest end was paid just over Medicare rates (108%). For outpatient services, Colorado hospital payments average over 3 times (312%) Medicare rates for the same services at the same hospitals, compared to a national average of 267%.

This latest update based on a national RAND Corporation analysis that included 2016-2018 claims in the Colorado All Payer Claims Database (CO APCD), expands crucial cost transparency efforts to fill information gaps on insurance payments in Colorado and across the nation. This data can be used by employers, consumers, and others to make informed decisions regarding purchasing health care with the ultimate goal of driving down costs.

The data set now includes trend information from 2017-2018 and provides a look at inpatient and outpatient services at the hospital, county, and Division of Insurance (DOI) level. Additional insights on hospital and DOI rankings can be viewed in two breakout infographics.

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