Colorado Unveils Public Option Reimbursement Rates That Officials Say Will Help Hospitals Remain Profitable
The Colorado Health Insurance Option formula's base rate is 155% of Medicare rates, but hospitals' individual rates would vary based on hospital type. Hospitals are still wary about the option, though. It seems likely hospitals will have to raise costs for people with insurance plans that aren’t part of the state option, said Katherine Mulready, senior vice president and chief strategy officer for the Colorado Hospital Association.
Modern Healthcare:
Colorado Unveils Hospital Rates For Its Public-Option Plan
Colorado officials on Monday unveiled the state's formula for hospital reimbursement rates under the state's proposed public-option insurance program. The Colorado Health Insurance Option formula's base rate is 155% of Medicare rates, but hospitals' individual rates would vary based on hospital type, payer mix and how efficiently they deliver care. Colorado hospitals could cover the costs of providing care at 143% of Medicare rates, according to a state analysis of 2018 Medicare payment data collected by the Colorado Hospital Association and the Colorado Healthcare Affordability Sustainability Enterprise board from the state's hospitals. (Brady, 2/25)
Denver Post:
Colorado Consumers Could Save Up To 20% Under State Health Insurance Option, Polis Says
The formula is almost certain to run into stiff opposition from the Colorado Hospital Association. But lawmakers say the rates are better than what some hospitals are currently receiving and the rate-setting will provide more certainty about how much hospitals can expect to be reimbursed for services. And the plan will benefit rural hospitals, said Rep. Dylan Roberts, a Democrat from Avon who is sponsoring the bill. He said he anticipates the state option bill will receive bipartisan support, despite the vocal opposition. Lawmakers wanted to release the reimbursement formula before the bill was introduced to be transparent and explain the process of developing it, he said. (Wingerter, 2/24)
Colorado Public Radio:
Polis Releases The Next Key Step For A Colorado Public Health Insurance Option
The Colorado Health Insurance Option is the central focus of a much-anticipated document that lays out the administration’s push to tackle the thorny issue of skyrocketing health care costs. Those costs have risen to the top of voters’ concerns in the 2020 election year. It achieves those savings by wrestling down reimbursement rates to hospitals to ones more similar to government programs like Medicare and Medicaid. The new proposed formula released Monday sets a base reimbursement rate of 155 percent of the Medicare rates. That figure is more generous than both the average at which Colorado hospitals break even — currently 143 percent — and at which hospitals nationally turn a profit. (Daley and Cleveland, 2/24)
Bloomberg:
What Colorado’s Public Health Insurance Push Means For Democrats
For Democratic presidential candidates contemplating sweeping health-care overhauls, what happens in Colorado over the next few months will be instructive. Lawmakers in Denver are preparing to vote on a state-sponsored health plan that would compete with private insurance and offer lower premiums. Its approval could embolden Democrats eyeing the White House. (Tozzi and Court, 2/26)
