h_phc_2016a_2017-01-09t09:09:19z4 Hearing Summary

Date: 01/09/2017

01:36 PM -- Presentation on the Health Cost and Geographic Areas Study



The committee came back to order.



Marguerite Salazar, Commissioner of Insurance, presented on the Colorado Total Health Cost and Geographic Areas 2016 Study. Handouts related to her presentation were delivered to the committee (Attachments G, H, and I). She explained that the Division of Insurance (DOI) in the Department of Regulatory Agencies (DORA) contracted with Lewis & Ellis, Inc. to evaluate the nine geographic areas in Colorado created by the Federal Patient Protection and Affordable Care Act. She introduced the health cost study, and summarized the findings for the committee.



170109 AttachG.pdf170109 AttachH.pdf170109 AttachI.pdf



01:44 PM



Ms. Salazar described the health insurance cost differences between the geographical regions. She went over statistics on cost of care and utilization of care in different regions, noting that region 9, the western part of the state, typically has the highest cost for care in the state. Michael Muldoon, DOI, described the data used for the study. He detailed the types of care that are more expensive in region 9.



01:53 PM



Ms. Salazer and Mr. Muldoon responded to questions from the committee regarding the contributing factors to high cost of care in region 9. In response to a question, Ms. Salazar discussed cost of care rates in Pueblo over time.



02:06 PM



Ms. Salazar described new insurance models that encourage partnership between carriers and providers. Mr. Muldoon explained that DOI plans to gather more data and perform detailed evaluations on cost in different areas of the state. In response to questions, Mr. Muldoon explained how insurance rates are set and told the committee of changes in the individual marketplace in 2017. The committee continued to discuss negotiation of rates for health care services in different geographical areas.



02:19 PM



Mr. Muldoon responded to questions regarding Medicaid rates, and explained the DOI's role in the insurance market. Matthew Mortier, DOI, responded to questions from the committee regarding network adequacy requirements.