Privately insured Colorado Households pay thousands more for processes than Medicare beneficiaries

A latest report from the Center for Improving Value in Health Care discloses important variation in payments in the state Colorado for hip and knee replacements between private health insurance payers and Medicare: Colorado residents with private insurance in the northeast pay $55,000 more than their neighbours with Medicare, while those in Denver pay $17,000 over Medicare costs.

New national studies have unveiled minor to no correlation between Medicare and commercial payer healthcare spending in the similar locality. But places such as Grand Junction, Colorado -- historically praised for its fewer prices to treat Medicare recipients -- have come under recent scrutiny for higher-than-average commercial healthcare prices relative to other places in the state and nation.

The Western Slope region of state Colorado, which encompasses Grand Junction, has the 3^rd greatest commercial prices in the state after the northeast and mountain regions. Colorado residents with commercial insurance along the Western Slope pay nearly $47,000 or $26,000 more than Medicare recipients getting a knee or hip replacement. In the mountain area, the disparity between commercial insurance and what Medicare pays is in the proposed excess of $43,000, and in the northeast it exceeds to $55,000 -- equating to a 232% point.

The report recommends that few changes in prices across regions is hoped, due primarily to the higher price of living and the relative health of the population. It is not apparent readily, although, why commercially insured Colorado residents in the northeast pay twice as much, $78,000, as their neighbours in the southeast, $39,000, for the similar service.

"Recognizing such dramatic fluctuations in costs between payers provides us a chance to inquire why this is happening, whether it is warranted and where we have chances to decrease costs and make better care," claimed CIVHC CEO and President Ana English.

Various groups in the state, involving the Colorado Commission on Affordable Health Care, are looking at information in the Colorado all payer claims database, and elsewhere, to pinpoint where the state can make improvements. This recent research shows that, at a minimum, higher-cost regions have chances to explore what drives increased spending regionally, and to inquire what practices lower-cost regions utilizes to keep prices down.