A digest of health care information about cost savings, public policy, and staying healthy in retirement.
The Center for Improving Value in Health Care (CIVHC) is an objective, not-for-profit organization working with partners to alter the trajectory of health care. In its role as administrator of the Colorado All Payer Claims Database, the state’s most comprehensive source of health care cost information, CIVHC empowers individuals, communities, and organizations to achieve the Triple Aim of better health, better care, and lower costs.
CIVHC’s Shop for Care tool makes publicly available CIVHC data easy to access, allowing health care consumers to compare prices and patient experiences at Colorado health care facilities for certain health care services.
For example, recent information released in the tool shows thatconsumers could save thousands of dollars by shopping for imaging services. Specifically, by searching for high value providers, Coloradans could save:
- $2,000-$6,000 on CT Scans
- $3,000-$4,500 on MRI Scans
- $800-$1,000 on Ultrasounds
- $800 on Bone Density Scans
- $4,000 on Heart Vessel Studies
- $300-$1,000 on X-Rays
The Shop for Care toolprovides quality information and prices from Colorado facilities for nearly 40 procedures including imaging and high cost episode-based procedures such as births and knee replacements. Patients also can save $35,000 between the lowest- and highest-cost facility for knee replacements, $32,000 for a hip replacement, and $20,000 on gall bladder surgery, among other services. CIVHC will conduct an interactive podcast about this tool on May 10.
A 65-year old couple retiring in 2019 can expect to spend $285,000 in health care and medical expenses throughout retirement, compared with $280,000 in 2018, according to Fidelity’s annual Retiree Health Care Cost Estimate. For single retirees, the health care cost estimate is $150,000 for women and $135,000 for men. Fidelity notes that the past two years combined have seen a slower rise (3.6 percent) than in the previous two (2015 to 2017), which saw the estimate grow to $275,000 from $245,000 (up a total of 12.2 percent). However, even without the same rate of growth, some retirees are still surprised by today’s cost of health care. A survey found 81 percent of Americans believe it would be very or extremely valuable for their financial adviser to include health care costs in their retirement planning.
House panel puts hospitals and specialists on the spot for surprise bills – Modern HealthcareHospitals took a beating in the first House legislative hearing on surprise medical bills, and major trade groups followed up with a letter to the committee leaders to defend their position. The House Education and Labor Committee’s health panel convened the bipartisan hearing and called witnesses from the policy and consumer advocacy worlds rather than industry.
Summit County’s groundbreaking Peak Health Alliance health care collaborative has just made its first major step to becoming a reality. Peak Health and Centura Health, which owns St. Anthony Summit Medical Center, have successfully negotiated a contract to make Centura the primary health care provider for the Peak Health Alliance network when it goes live next year. The negotiations have been ongoing for several months with different health care delivery providers, and the next step will be to get insurance companies to bid for the rates for the fee schedule Peak Health negotiated with Centura and secondary providers. Peak Health, when online, will represent individuals and employees of small and large employers in Summit County.
It seems like every state senator and representative is trying to pass a health care bill this session. Republicans, Democrats, and the new governor all put lowering medical costs toward the top of their to-do lists in 2019, and the result has been dozens of bills — some of them overlapping — that seek to lower the cost of health care in different ways. Some of them, however, hinge on getting support not only at the Capitol but also from the Trump administration.
Cardiovascular disease (CVD) is the number-one cause of death in both men and women. Statistics from the American Heart Association show that one woman every minute dies from heart disease in the U.S. An estimated 44 million American women are affected by CVD, and 90 percent have one or more risk factors for it. The good news is that 80 percent of heart attacks and strokes can be prevented by lifestyle changes. But when heart attacks do occur, fewer women than men survive the first attack. That’s largely because heart-disease symptoms in women can be different from those in men — and even some physicians misread the subtleties.
As Democratic presidential primary candidates try to walk a political tightrope between the party’s progressive and center-left wings, they face increasing pressure to outline the details of their health reform proposals. Sen. Bernie Sanders (I-Vt.) has reaffirmed his stance by reintroducing a “Medicare-for-all” bill, the idea that fueled his 2016 presidential run. As with its previous iterations, Sanders’ latest bill would establish a national single-payer “Medicare” system with vastly expanded benefits, prohibit private plans from competing with Medicare, and eliminate cost sharing. New in this version is a universal provision for long-term care in home and community settings (but Medicaid would continue to cover institutional care).
CCHI recently coordinated with the Altarum Healthcare Value Hub on a poll to understand more about how Coloradans are experiencing the health care system. The survey looked at a variety of health care issues and perceptions in Colorado including affordability, surprise medical bills, prescription drug costs, hospital costs quality, and regional variations in how Coloradans experience health care.
Governor Polis considers his focus on health care policy to be one of the highlights of his first 100 days in office. He’s promised to import cheaper drugs from Canada and lower premiums. He even created the new Office of Saving People Money on Health Care. But much of Polis’ agenda actually falls on lawmakers who have to craft the proposals and pass them. So far this session, they’ve passed bills to increase transparency of hospital costs, study a state-run insurance option, and promote insurance cooperatives. But with the legislative session nearing an end, some of the most consequential pieces of health care legislation haven’t crossed the finish line yet, making some people start to wonder if there’s enough time left.
Colorado’s House has sent to Gov. Jared Polis a bill to develop a state-run health insurance option. The bill directs state agencies to recommend a plan to compete with private insurance plans and those offered on Colorado’s health care exchange. The House approved the legislation, House Bill 1004, by a 45-19 vote last month. The public option legislation directs the Department of Health Care Policy and Financing and the Department of Regulatory Agencies to deliver a proposal in November. The plan would assess costs, funding sources, necessary federal permissions and funding, consumer eligibility, and who in government would run the program. Enrollment could begin in 2020 and a plan, if approved by the federal government, could operate in 2021.
In 10 years, more than half of middle-income Americans age 75 or older will not be able to afford to pay for yearly assisted living rent or medical expenses, according to a study published Wednesday in Health Affairs. The researchers used demographic and income data to project estimates of a portion of the senior population, those who will be 75 or older in 2029, with a focus on those in the middle-income range — currently $25,001 to $74,298 per year for those ages 75 to 84. And it doesn’t look good for that group because of the rising costs of housing and health care. The researchers estimated that the number of middle-income elders in the U.S. will nearly double, growing from 7.9 million to 14.4 million by 2029. They will make up the biggest share of seniors, at 43 percent.