Colorado Gov. Jared Polis on Feb. 24 released the reimbursement formula for the state's pending public option plan, The Denver Post reports.
Colorado's "public option" plan would be sold by private companies who will operate under more cost control regulations. One of the ways it will achieve savings is by capping hospital reimbursement.
The formula released Feb. 24 shows the plan would reimburse hospitals 155 percent of Medicare rates, or more depending on hospital-specific criteria like critical access designation and payer mix. The Post notes private payers reimbursed 269 percent of Medicare rates in 2017.
The public option plan therefore represents a potentially significant drop in reimbursement for some hospitals. The formula is expected to face "stiff opposition" from the Colorado Hospital Association, according to the report. CHA Chief Strategy Officer Katherine Mulready told the Post the association has concerns the cuts would require hospitals to increase charges to people with private plans.
The proposal assumes hospitals break even at 143 percent of Medicare rates.
Read the full story here.
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