New Infographic Shows 50-85% of Total Prices are Facility-Related

New data shows what percentage of the total payments for common health care procedures are typically paid to Colorado facilities. The Shop for Care facility price and quality tool made available by Center for Improving Value in Health Care (CIVHC) using claims from the Colorado All Payer Claims Database (CO APCD) provides total price information for high cost and high volume procedures. The infographic released today shows that for the 11 services studied, 50-85 percent of all payments related to a procedure are paid to the facility where the procedure takes place.

Total price on the Shop for Care tool is determined based on the full “episode” of care which includes everything that happens before, during and after a procedure. In the case of knee surgery, for example, the total price includes imaging tests, surgeon or other doctor’s visits before the surgery, payments related to the surgery itself including the operating room, device, anesthesiology and surgeon fees, and all post-op care including pain medications and physical therapy.

Cataract surgery has the lowest percentage of payments attributed to the facility (49 percent), while hip and knee replacement have the highest at 85 percent of the total statewide median episode payment.

Prices also vary widely from the lowest facility to the highest facility for each procedure, and consumers can shop by named hospital or ambulatory surgery center on the interactive Shop for Care page. In addition to total prices, patient experience scores are available for hospitals, enabling consumers to make informed decisions on where to go for high value care.


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