In 2017 the Colorado General Assembly passed legislation requiring greater transparency in provider prices enabling consumers to be better informed. Beginning Jan. 1, 2018 physicians will need to disclose to consumers their charges for the 15 most common services they provide when payment is made directly by the patients rather than by a third party. 

This applies to physicians in a solo practice, medical group, independent practice association or professional corporation. Health care providers are required to make available to the public the prices for at least the 15 most common health care services provided. Such information should be available in a single document, either electronically or by posting conspicuously on the provider's website if one exists.

Read more about the new provision here.  

SIM practices are at the forefront of innovation, re-evaluating their processes and taking steps to deliver comprehensive primary care and integrate behavioral health into their patient offerings. This is an exciting time for Colorado practices that want to start the process of transitioning from volume- to value-based health care delivery models. 

An increasing number of health care professionals -- and payers -- are talking about value-based reimbursement while a group of Colorado practices are receiving support to make it a reality through the Colorado State Innovation Model (SIM) initiative. The Colorado State Innovation Model (SIM) is now accepting applications for the third and final cohort of practices. The SIM team encourages practices to take advantage of this opportunity to progress along the continuum of integrated care and test alternative payment models. The application closes Jan. 10.

Click here for more information and to access the application.

Utilization of services is one of the key drivers of health care spending. In addition, understanding how and where Coloradans receive care is important for understanding care patterns that could impact health and to inform where opportunities to improve health care access may exist. 

A new interactive health care utilization report from CIVHC based on data in the Colorado All Payer Claims Database (CO APCD) provides information to help stakeholders find ways to reduce variation in the way care is being utilized with the ultimate goal of improving health and the quality of care while reducing costs. The  report allows users to search by demographics including type of health insurance coverage (Medicaid, Commercial and Medicare Advantage), age and gender, and across years (2012-2015) for a variety of metrics.

Click here to access the report.

From April 2018 to April 2019, the Centers for Medicare and Medicaid Services will mail new Medicare cards to all active Medicare beneficiaries.  The New Medicare Card removes Social Security numbers from Medicare cards due to concerns about identity theft.  The new cards have a Medicare Beneficiary Identifier (MBI) instead of the Social Security Number-based identifier known as the Health Insurance Claim Number (HICN).

Practices must be prepared to use MBIs starting April 1, 2018, as patients new to the Medicare program beginning in April 2018 will only have cards with MBIs.  From April 1, 2018 to Dec. 31, 2019, the federal CMS will accept both HICNs and MBIs on Medicare transactions (including eligibility requests and claims) for beneficiaries in the Medicare program prior to April 1, 2018 (i.e., those who  received a HICN).  Beginning in January 2020, physicians may only use MBIs. (Exceptions may include appeals and retrospective adjustments.) 

Read more here from the AMA about how to prepare your practice and your patients.