The online Shop for Care tool, based on information in the Colorado All Payer Claims Database (CO APCD), now includes more procedures, additional facilities and new quality information. By using this tool, people with and without insurance can save thousands of dollars and help reduce health care spending in the state.

The searchable information, produced by the Center for Improving Value in Health Care (CIVHC), includes updated 2018 prices for imaging services like x-rays, CT scans and MRIs, and episode prices for 11 new hospital and outpatient procedures including hysterectomies, colorectal resections and more.

Episode prices provide an estimate of the total costs associated with all aspects of care that occur before, during and after a procedure. In addition to the total price, this new update also provides price breakouts of the different components of care before, during and after the procedure. This new data helps patients understand how much they (and their insurance company, if insured), can expect to pay in total between bills from hospitals, doctors, rehabilitation facilities, lab centers, pharmacies and more.

“Price transparency can help those who suddenly lost health insurance or find themselves on a new high deductible plan make informed decisions that can benefit them both financially and physically,” said Ana English, President and CEO at CIVHC. “More and more people are facing COVID-19 related economic challenges that impact employment and health insurance coverage, and using a tool like this can help them save thousands of dollars.”

The website shows that price and quality vary significantly across Colorado, and paying more does not always mean better patient experience or outcomes. Patients shopping for episode-based care in Colorado can save significantly by shopping around – bariatric surgery prices range from $26,000 to $35,000, shoulder replacements range between $28,000 and $42,000, and coronary angioplasty prices are as low as $37,000 and as high as $76,000 at certain facilities.

This is the second update to the Shop for Care tool using episode-based prices, and CIVHC plans to start evaluating price trends year over year to determine if the transparency tool, along with other statewide cost-savings initiatives, are having an impact on reducing variation in prices for health care services.

“Research shows that providing public health care prices does have a positive effect on reducing price variation,” stated English. “Consumer decision making drives the market from the bottom up, employers use the information to negotiate payments and develop value-based incentive plans, and hospitals and other facilities use the information to remain competitive in the market place.”

In addition to using this tool, consumers are encouraged to access other publicly available sources of quality information and to ask their health insurance company about their specific out of pocket costs. People without insurance can use the information in the tool as a baseline to negotiate self-pay options with facilities of interest.

Additional public CO APCD analyses are available for COVID-19 and other important topics including Low Value Care, Medicare Reference-based Pricing, and more on the CIVHC website.

Resources: