The tool also allows users to see how commercial payments for things like routine office visits differ depending on the type of provider (behavioral health provider, dentist, etc.).
A separate calculator provides information about anesthesia payments based on several different factors that influence how these services are paid for. Using this tab, users can explore how anesthesia payments differ based on the procedure, where it was performed, type of provider, and the health status of the patient.
There is often a range of payments that occur for specific services, even for one specific payer type. To account for this variation, the tool provides average payments, as well as low, mid and high-end payments (25th, 50th, 60th and 75th percentiles). All current codes (effective in 2022) with sufficient volume (statewide claim volume of 30 or more) are included, and filters are available to address a number of variables that may impact payment results:
- Years: 2018, 2019, 2020, 2021, and 2022
- Payers: Commercial, Medicaid, Medicare Advantage, and Medicare Fee-for-Service
- Setting: Hospital (inpatient) vs. non-hospital (outpatient)
- Geography: Statewide, County, or Division of Insurance (DOI) rate setting region
- Provider Type/Setting: Specialists and General Practitioners, Home Health and Nursing Home, etc.
Price transparency tools are key to understanding areas of opportunity to reduce health inequities and barriers to accessing affordable health care services. Other price transparency tools and reports from CIVHC include:
- Shop for Care: Enables consumers, providers, and others to compare prices for select “shoppable” health care services and quality information on a named hospital and facility basis.
- Out-of-Network Report: Created to support Colorado’s No Surprises Billing Act, the data provides allowed amounts for professional and emergency services based on in-network benchmarks. This data is used to determine maximum payments for out-of-network provider services.
Resources
For more information or additional questions, contact us at info@civhc.org .