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Study: Single Geographical Rating Won't Cut Western Slope Health Costs

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Wednesday, August 3, 2016   

DENVER — The Colorado Division of Insurance has concluded the state should keep its nine geographical regions for determining health-insurance premiums and not move to a single-rating system.

The DOI study was commissioned by lawmakers after Western Slope residents realized they were being hit with disproportionately high costs. Adam Fox with the Colorado Consumer Health Initiative said a single rating system would only be a temporary fix.

"But if we don't address the cost drivers - that higher cost of care and that higher utilization - premiums are still going to increase, year after year,” Fox said. "And that's going to potentially exacerbate that problem statewide."

The study found that the higher costs for care, and a significantly higher rate of people accessing services in the mountain West - in some cases, 200 percent above statewide averages - led to higher claims and costs for insurers. The DOI said one solution might be to limit the extent to which companies can raise premiums based solely on region.

The report estimated a single-rating system could reduce Western premiums by as much as 20 percent, but it could also raise rates for Front Range residents by nine percent. Fox said the move could also backfire, causing companies to offer coverage only in lower-cost regions or leave Colorado altogether. He said it's important for the state to maintain a competitive marketplace.

"One of the main concerns really has to do with competition,” Fox said. "If there's only one insurer, it means that there's not really any competition for the insurers and the providers to negotiate each other down and set more reasonable rates."

Governor John Hickenlooper directed the DOI to develop recommendations built on the study before the end of the calendar year. Fox said consumers need to be a part of that process, and will work to ensure their voices are heard.


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