FAQs

  • Colorado is ranked 5th in the country for healthcare quality.
  • Colorado is 8th in the country for public health (obesity, smoking, suicide, mental health and mortality)
  • Colorado is 26th in the nation for healthcare access and affordability.
  • Colorado spent the 5th lowest amount per capita on healthcare (including Washington, D.C.) and nearly 17% less per person than the national average in 2014, the most recent year that CMS released expenditure data.
  • Colorado residents pay below the national average for premiums, both in an absolute amount and as a percentage of median household income, according to a Commonwealth Fund analysis.
  • Coloradans pay 25.5% of their family income on healthcare premiums. While this is a heavy burden, Colorado is only one of five states to pay this percentage or less.

Trying to decipher medical bills and codes can seem daunting.  There are a number of websites that can help you:  Medical Billing and Coding, verywellhealth and FAIR Health are just a few.

Additionally, you can call the provider’s billing department and go to the FAQ n the provider’s website. Many providers also offer financial counselors to help walk you through your bill and payment.

This happens when you get a bill from a doctor, hospital, or another healthcare provider who isn’t part of your health plan’s network. Often, consumers didn’t know they were getting care from out-of-network providers.  Colorado lawmakers are currently trying to find a solution that protects the patients and healthcare providers.

In addition to the billing statement from the hospital, you may receive a bill from physicians who were involved in your care, such as your surgeon, anesthesiologist, radiologist or pathologist. If you were taken to the hospital by ambulance, you may also receive a bill from them.

Rate setting typically authorizes the government to regulate the prices hospitals can charge insurance companies and Medicaid. The price is often arbitrary and does not factor in how much doctors, nurses and facilities need to get paid to keep their doors open. As a result, rate setting leads to unintended consequences, such as a loss of critical services such as specialized NICU care, organ transplants and emergency trauma care.

The price of Insulin, used by 7 million Americans to live, nearly tripled from 2002 to 2013. Some doctors and researchers who study insulin say it is yet another example — along with EpiPens and decades-old generic drugs — of companies raising the cost of their products because of the lax regulatory environment around drug pricing. The drug companies – there are only three that manufacture insulin, resulting in little competition  –  blame pharmacy benefit managers (PBMs) for negotiating larger rebates for insurers, which they say forces them to raise prices.

Americans spend about $1,200 on prescriptions drugs a year.  Pharmaceutical companies have attributed high prices to research, development and innovation, arguing that new and improved drugs are more expensive.  But even after accounting for research and innovation drug companies are among the most profitable public businesses in America, according to AARP.  An analysis from the research company Global Data revealed that 9 out of 10 big pharmaceutical companies spend more on marketing than on research. And a new study from Health Affairs shows price increases are driven more by profits, not expensive new therapies or improvements in existing medications.

Price increases on existing drugs not only benefit drug makers but also health insurers, who can make more money through rebates on higher-priced drugs,  according to experts such as Gerard Anderson, professor of health policy and management at Johns Hopkins University

Not only do rising drug prices hurt consumers, it impacts patient care at hospitals and puts strains on hospital budgets and operations.