Prices continue to go up on the high end for most services making shopping for care imperative
The online Shop for Care Tool, based on information in the Colorado All Payer Claims Database (CO APCD), now offers prices for more health care services than ever before. As health care costs continue to rise, this tool empowers Colorado consumers by allowing them to compare procedure costs and quality for over 53 health care services at over 100 hospitals and facilities across the state. Equipped with transparent price and quality information, consumers can select facilities that provide the highest value care, while facilities and providers themselves can use the data to understand how their prices compare, and to make informed referral decisions.
People without insurance can use the information in the tool as a baseline to negotiate self-pay options with facilities of interest. For those with health insurance coverage, shopping for health care services is still important regardless of your insurance plan or patient responsibility because going to a high cost facility could contribute to a rise in premiums the following year.
Making health care affordable continues to be a priority for the Colorado and the nation, a key component of which is making transparent price information available publicly. A new federal hospital price transparency law recently required hospitals to post prices online. However, without a comparison tool like Shop for Care, it’s difficult for consumers to truly shop around, and prices are not always inclusive of everything patients and health plans may pay. Care at a hospital can also be more expensive than using an alternative facility type like a free-standing imaging center. One of the benefits of the CO APCD is being able to evaluate prices for the same service across multiple facility types, and estimate all costs that may be incurred pre-, during and post-procedure.
“The federal requirement for individual hospitals to report prices online is an important step towards transparency, but it is not a user-friendly way for consumers to compare prices across all facility types at once,” said Ana English, President and CEO at Center for Improving Value in Health Care (CIVHC). “Thanks to the comprehensive data available in the CO APCD, Colorado is one of only a few states in the nation that has had a robust consumer-friendly health care shopping tool for several years.”
In Colorado, the high-end price for many services continues to rise. For example, for C-sections, the highest price facility rose 47% between 2017 and 2019. The highest price for knee arthroscopy increased 57%, and prices rose 26% for a wrist x-ray.
The searchable information, produced by the Center for Improving Value in Health Care (CIVHC), includes updated 2020 prices for imaging services like x-rays, CT scans, and MRIs. The tool also includes updated 2019-episode prices for procedures such as knee and hip replacement, births, hysterectomies, colonoscopies and more. 
Episode prices estimate the total costs associated with all aspects of care that occur before, during, and after a procedure. This data helps patients understand how much they and their insurance company (if insured) can expect to pay in total between bills from hospitals, doctors, rehabilitation facilities, lab centers, pharmacies, and more.
Along with using this tool, consumers are encouraged to access other publicly available sources of quality information and to ask their health insurance company about their specific out of pocket costs.
As noted, providers and facilities can also use the tool to understand how their prices and quality compares with their peers across the state. This data can also help payers, health systems, providers and others engaged in value-based care programs by identifying high value referral sources for their patients.
Resources:
- Shop for Care Tool
- Infographic Comparing low and high prices – Imaging
- Infographic Comparing low and high prices – Procedures
- Plaintalk Blog on Importance of Shopping for Care
- FAQs or contact us at info@civhc.org