Information About the Colorado Hospital Price Report

The Colorado Hospital Association and the Colorado Division of Insurance are required to publish this information on a website in accordance with Colorado law (§§ 25-3-705 and 10-16-134, C.R.S.). This is the first year the data is being published, as the law requiring publication of this information was passed in 2008. The General Assembly hopes the information will help consumers make educated choices regarding their health care needs, and require health care providers and carriers to be more transparent about their prices and reimbursement rates.

The most common basis for reporting the data to both hospitals and insurers is the Medicare Severity Diagnosis Related Group Medicare Severity Diagnosis Related Group (MS-DRG) developed by the Federal Centers for Medicare and Medicaid Services. If you are unsure as to the Medicare Severity Diagnosis Related Group (MS-DRG) for which you are being admitted, check with your physician.

Hospitals reported their average billed charges to the Colorado Hospital Association, and carriers reported their average reimbursement rates to the Division of Insurance. The hospital information is inclusive of all payers both public and private. The insurance information is limited to care covered by private insurance companies. It should be noted that not all carriers use Medicare Severity Diagnosis Related Group (MS-DRG) codes to track their data, and that carriers did their best to sift information into these categories if it was not already tracked in this format.

Only some of the hospital procedures included in this data are covered by health benefit plans administered by insurance companies, health maintenance organizations, nonprofits, and other carriers. Approximately 20% of the procedures shown from the hospital data were covered by carriers, according to the below numbers. Procedures that are not covered by a health benefit plan or health insurance are paid for by the patient or another responsible party, such as a self-insured employer.