Health Plan Rate Analysis

Colorado APCD website screenshot
February 2014

Contact: Center for Improving Value in Health Care

Background: The Colorado Network was working with one of its network members to avoid paying higher costs to a health plan, which would force that member to increase fees.

Goal: Analyze high cost/high utilization DRGs by payer to determine appropriate rates with health plans.

Data Analyzed: Average charged, average allowed, average plan paid, average member liability for selected DRGs by Payer for Rural Hospitals and The Colorado Network member.

Results: In progress.

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