Hospital Rate-Setting
Rate-Setting Imposes Dangerous Restrictions on Hospitals
What You Need to Know:
Like hospitals, community health centers are struggling with Colorado’s failed Medicaid re-enrollment effort following the COVID-19 public health emergency. Solutions must support the entire health care system and force meaningful accountability for the state’s failures. Proposals that deplete one part of the safety net to save another are destabilizing, dangerous, and must be rejected.
Key Points/Hospital Perspective:
- Hospitals stand in solidarity with community health centers around the state and agree that the health care safety net must be safeguarded from the financial crisis created by Colorado’s failed Medicaid redetermination.
- Proposals for rate-setting restrictions will reduce reimbursement at a time when 70 percent of Colorado hospitals are financially unsustainable and there is unprecedented uncertainty at the federal level.
- Hospitals already fund $5 billion for the state’s health care system with current payments for Medicaid, HCPF administrative costs, out-of-network hospital rate setting, Colorado Option rate setting, and more.
CHA Contact: Bridget Frazier, senior manager of public policy | [email protected]
Rate Setting Is Dangerous Policy
Other states have attempted to implement reference-based pricing, based on a percentage of Medicare, with disastrous results. These changes reduced provider reimbursement by billions and disrupted strong provider networks.
Remember: Medicare fails to reimburse hospitals for the cost of care.
Similar bills in other states drove providers out of network, decreasing access to care:
- In North Carolina, no hospital participated in the network.
- In Montana, just 14 out of 59 hospitals participated in the network.
- In Oregon, only 24 out of 70 hospitals participated in the network.