Understanding Personal Health Care Costs

Health care is a vast and complex industry that can be daunting for patients and their families to navigate. Colorado Hospital Association and its members are dedicated to ensuring that patients are able to get the right care at the right time while also having the right information.

If a patient has health insurance, the best and most accurate way to find information about their health care costs is to contact their health insurance provider, which will have answers pertaining to hospitals, providers and services covered under their plan. Health insurance companies will also have patient-specific information regarding costs they will be responsible for, such as deductibles and out-of-pocket maximums.

If a patient does not have health insurance, the best way to get accurate pricing information is by calling their hospital directly and requesting a price estimate. Most hospitals in Colorado offer discounted rates and charity care for patients that qualify and are not covered by insurance, in addition to payment plans for any out-of-pocket costs. Find a hospital here.

Why Quality Matters

The price of health care is an important subject, but it is not where the conversation on transparency ends. The quality of the care provided and the outcomes of that care are equally, if not more important. CHA maintains a website report card with all the data from Colorado hospitals including patient safety, outcomes and other quality metrics where consumers can easily see how their hospital ranks against others when it comes to the quality of care provided.

Other Resources

The Healthcare Financial Management Association (HFMA) released a comprehensive consumer guide for understanding health care costs and pricing.

The Colorado Hospital Report Card gives consumers more information about average hospital charges and average reimbursement rates paid by insurance companies.

The DORA Price Report contains information on the average hospital charges for specific diagnosed procedures compared to the average reimbursement that insurance companies will pay for patients.

This database is the state’s most comprehensive source of health care insurance claims information representing the majority of covered individuals in the state.

CHA’s Center for Health Information and Data Analytics released a study that shows hospitals in states that chose to expand Medicaid under the Affordable Care Act saw significantly more Medicaid patients and a related reduction in self-pay and charity care cases; whereas, hospitals in states that chose not to expand Medicaid experienced no changes outside normal variation in Medicaid volume or self-pay and charity care cases. Click here for the full report. For the news release, click here.