Hip, knee replacement rates vary by up to 232% among Colorado insurers: 5 findings

In Colorado, those with private health insurance are paying significantly more than Medicare beneficiaries for hip and knee replacements, according to a report by the Center for Improving Value in Health Care.

Here are five findings from the report:

1. In the northeast, Coloradans pay $55,000 more than those with Medicare, a mark-up of 232 percent.

2. People in the mountain region of Colorado pay $43,000 more than Medicare prices.

2. The Western Slope of Colorado, which includes Grand Junction, Colo., has the third highest commercial costs in the state after the northeast and mountain regions. People in this region pay $26,000 more than Medicare beneficiaries.

3. Additionally, Coloradans with commercial insurance in the northeast pay around $78,000 for hip and knee replacements, whereas those with commercial insurance in Denver pay only $39,000.

4. Some variation in costs across regions is expected, however the reason for the dramatic shifts across regions in Colorado is not clear.

5. Many groups in the state, including the Colorado Commission on Affordable Health Care, are exploring ways to pinpoint improvement areas.

"Identifying such dramatic fluctuations in prices between payers gives us an opportunity to ask why this is happening, whether it's warranted and where we have opportunities to reduce costs and improve care," said Ana English, CEO and president of CIVHC. "This type of analysis from the Colorado All Payer Claims Database suggests that we have the potential to do a much better job controlling costs in some areas."

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