UCHealth hospitals across Colorado continue to discover ways to reduce health care costs and provide affordable care for patients.
Health care is complex and UCHealth is at the forefront of innovation that helps people navigate the broad health care landscape. UCHealth is the largest provider of Medicaid services in Colorado. In 2019, UCHealth provided $367 million in uncompensated care – a little more than $1 million a day. In all, UCHealth provided $933 million in community benefit.
Each day, UCHealth continues to advance health care in Colorado by:
- Expanding opportunities for people to access our services through financial assistance, technology and a commitment to Medicaid services.
- Investing more than $100 million to expand access to behavioral health care and create greater awareness of issues including opioid addiction and suicide.
- Pushing the boundaries of medicine and bringing advanced care, including comprehensive transplant services and excellent oncology outcomes to patients across the Rocky Mountain region.
UCHealth has a price transparency tool that informs patients of the cost of their health care, an education campaign to direct patients to the appropriate level of emergency care and a program called Virtual Urgent Care that gives patients – even the uninsured – an affordable way to access a doctor from anywhere in Colorado via phone or through a computer.
Here are some of the ways in which UCHealth is helping consumers navigate the complexity of health care and making health care more affordable:
Price transparency tool
UCHealth is one of the nation’s first health care systems to provide individualized price estimates that are specific to patients’ own insurance carriers. These estimates are available via the online patient portal, the mobile app, My UCHealth Connection, and through a dedicated call center.
“UCHealth is focused on providing an excellent experience for our patients, and this includes increasing transparency in the insurance and billing process,” said UCHealth President and CEO Elizabeth Concordia. “This innovative service helps patients understand and plan for their out-of-pocket expenses for health care.”
Historically, accurate estimates have been difficult for hospitals to provide because a patient’s out-of-pocket responsibility depends on their insurance plan details as well as how much of their deductible and out-of-pocket maximum they have reached, information only the insurance company and patient have. A patient with a $5,000 high-deductible insurance plan would have a dramatically different responsibility than a patient with a low deductible or someone who had already reached their out-of-pocket maximum for the year.
UCHealth’s estimating tool can immediately connect with an insurance plan, confirm a patient’s insurance information, and even identify how much of their deductible and out-of-pocket maximum the patient has already met during their plan year. The patient then can select from multiple UCHealth locations and services to compare costs and receive an estimate. Services include MRIs, CT scans, deliveries, orthopedic surgeries, cataract removal and more.
“Businesses and insurance companies have been using high-deductible insurance plans to shift more health care costs onto consumers,” said UCHealth Chief Financial Officer Dan Rieber. “This estimates tool gives patients the power to make informed health care choices, and it also can help guide patients as they select an insurance plan that’s right for them.”
Current patients can login online to UCHealth’s My Health Connection portal or through the UCHealth mobile app to access estimates. New patients, or those without a My Health Connection account, can create an account.
Affordable alternatives to costly medication
UCHealth hospitals and clinics use SwiftRx Direct to help physicians quickly and easily find affordable alternatives to costly medications specific to a patient’s health needs and insurance benefits.
“Having prescription pricing information at physicians’ fingertips when we’re meeting with a patient is a huge step forward. This helps avoid the surprise a patient might have when they get to the pharmacy only to find out the medication prescribed is unreasonably expensive,” said UCHealth Chief Innovation Officer Dr. Richard Zane, who is also the professor and chair of emergency medicine at the University of Colorado School of Medicine. “This tool helps providers know the costs ahead of time and discuss them with patients.”
Dr. CT Lin, an internal medicine physician with UCHealth and the system’s chief medical information officer, said the tool enabled him to change a prescription from tablets to capsules, reducing the co-pay estimate for the patient from $250 to $50.
UCHealth is the first health care system in the country to go live with this tool within its electronic medical record, Epic, making the RxRevu’s SwiftRxÒ Direct solution available to thousands of providers. UCHealth’s CARE Innovation Center has been a close partner with RxRevu, developing and testing the technology together and seamlessly integrating it into the electronic medical record system.
Employer Value Solutions program
UCHealth is encouraging more employers to offer innovative health plan networks that can help them reduce their health care budget and lower the cost of care for employees.
When employers partner with UCHealth to develop specialized, high-performing networks for their employees, they have access to additional, double-digit discounts on medical care provided at UCHealth and partner locations, which is helping to produce more affordable health insurance premiums. More than 25 employers in the state are currently using these options; however, many businesses are unaware of the option to save costs with the Employer Value Solutions program.
Plans that have access to the discounted medical care include:
- Anthem Blue Cross and Blue Shield Pathway (HMO and PPO available)
- Cigna LocalPlus
- UCHealth Plan Administrators
“Health care and insurance costs are a significant problem for people throughout Colorado. Partnering with employers and insurers to offer significant discounts through high-performing provider networks is one of many initiatives UCHealth is taking to reduce the cost of health care. However, everyone – pharmaceutical companies, device manufacturers, insurance companies and others – must do their part to lower premiums,” said UCHealth President and CEO Elizabeth Concordia.
Affordable, same-day clinic provides tender, loving CARE during difficult cancer treatments
Getting a cancer diagnosis is rough enough.
Then the treatments for cancer can make patients feel even worse for a time. Some struggle with symptoms like severe nausea, dehydration and pain.
That’s where providers at the UCHealth CARE Clinic come in. CARE stands for Clinical Assessment and Rapid Evaluation. And the clinic is located at the University of Colorado Cancer Center on the Anschutz Medical Campus in Aurora.
Nurses, physician assistants and nurse practitioners, who are specially trained in oncology and internal medicine, provide TLC to cancer patients at the CARE Clinic so they can continue with their cancer treatments. The center is essentially an Urgent Care clinic reserved just for cancer survivors. This helps patients avoid costly visits to Emergency Departments.
“We try to keep patients out of the hospital,” said Sarena Zabilla, an oncology nurse who helps manage the CARE Clinic.
Longer-term help for people struggling with opioids
As the opioid crisis has ravaged the U.S., people struggling with addiction frequently need help in hospital ERs, the most expensive place to get care.
To improve access to treatment, help patients get longer-term help and prevent costly future hospital trips, social workers and medical providers in the emergency department at UCHealth University of Colorado Hospital launched a program in 2018 to provide what’s known as “medication assisted treatment.” Before patients leave the ER, those who are willing to follow up with a community provider for ongoing substance use treatment can receive a medication called buprenorphine, which helps reduce withdrawal symptoms and cravings for highly addictive opioids.
The program has been working well. Patients get help when they need it most and, along with medication, they leave the hospital with appointments to see a provider for ongoing treatment within the next two to five days. They can also call the hospital social workers for additional assistance after discharge.
“It’s a very effective intervention for our patients who have opioid use disorder,” said Angela Khoshnoud, who oversees social workers in the Emergency Department and manages the program.
“Our social work team breaks down a lot of barriers for patients. We work with each individual to figure out which community treatment program will set them up for success,” Khoshnoud said.
Telestroke at Yampa Valley Medical Center
UCHealth Yampa Valley Medical Center in Steamboat Springs serves a very active community. There are countless options each season in which locals participate, and a significant number of visitors frequent the Yampa Valley throughout the year – and with activity comes the risk of injury.
As a Level III trauma center, Yampa Valley Medical Center is capable of caring for a wide range of injuries, including trauma patients with hemodynamically-stable multi-system traumas, trauma patients on ventilators and trauma patients with non-surgical brain bleeds, following consultation with a Level I or Level II facility.
But sometimes, there isn’t an activity associated with an injury. Take a stroke, for instance. Diagnosis and accuracy of diagnosis are two key factors in a patient’s survival. When diagnosed accurately, the administration of tPA, a clot-busting drug, can be lifesaving; if diagnosed inaccurately, the administration of tPA can cause brain bleeds and even death.
Thanks to telestroke technology in the emergency department at YVMC, patients presenting with stroke or stroke-like symptoms can have the eyes of a neurologist on them in minutes. The neurologist views the patient over a screen and works with the in-room emergency medicine physician to assess the patient’s symptoms.
From November 2018 to October 2019, telestroke was used for 61 patients at YVMC. It took an average of 6 minutes for a neurologist to be on screen, with nearly 2/3 of patients being able to stay in the local community for care. Had the technology not been in place, many, if not all, of those patients would have been transferred to another facility for further evaluation, diagnosis or treatment. Instead, additional travel, time, stress and cost were avoided.
Aspen Club in northern Colorado
For more than 30 years, UCHealth Aspen Club has been helping people ages 50 and older to “ease gracefully” into their older years. From fitness and nutrition, to fall prevention and chronic disease management – and even the benefits of laughter and financial planning – the Aspen Club tackles issues that matter to seniors. Membership is free.
The Aspen Club follows the lead of UCHealth’s many research initiatives by selecting evidence-based programs to offer 13,000 members. Educational programs such as Memory and Brain Health, Parkinson’s Wellness Recovery Class and Caregiving Resources help residents of northern Colorado.
The Aspen Club specializes in providing information about preventive care, including a blood pressure monitoring program, bone density and balance screenings, and Q&A with cardiologists and other health professionals. This helps reduce costs by educating patients on how to practice preventative health care in their homes.
“The Aspen Club has made me more health conscious, with its updates on health information and stressing the importance of health issues to help me take better care of my health,” said Linda Kovar, an Aspen Club member.
Family Medicine Center Food Bank
The connection between hunger and health is so strong that providers at the UCHealth Family Medicine Center have created a way to more easily care for both those important needs.
In the summer of 2017 — after 60% of FMC patients expressed a need — the center teamed with the Larimer County Food Bank to open a food bank location within the medical center in Fort Collins.
“We all know that lifestyle dramatically impacts health, and if people are struggling to simply find food to eat or are competing with paying for a medication or paying for food, their health will suffer,” said Dr. David Marchant, medical director of FMC.
In 2018, the pantry served 1,607 households, about 150 patients a day. Of those, 70% were low-income and enrolled in Medicaid. Each day, 2,500 pounds of food – about a third of it fresh produce – is provided.
“Food insecurity forces suboptimal health choices,” Marchant said. “By addressing food insecurity, we empower people to make better health decisions, which leads to a happier and more fulfilling life for themselves and their families.”
UCHealth Community Paramedic program
Over the years, the community paramedic program through UCHealth Emergency Medical Services has taken on different forms and roles, but its mission has always been consistent: providing the right care in the right setting.
Here are some ways UCHealth partners with the community to reduce costs:
- In Sept. 2015, UCHealth partnered with Larimer Country Community Corrections to tackle its high use of ambulance services and emergency rooms. In 2016, a once-a-week clinic is held at the correctional facility. In the first six months, visits to the Emergency Room by LCCC clients decreased 25% and ambulance use dropped 41%. Utilization of staff transports to the ER increased by 11%, demonstrating staff’s increase understanding of when an ambulance is necessary. This change resulted in $80,000 in savings during that timeframe.
- During busy summer months, a UCHealth paramedic joins a Larimer County boat ranger on weekends and holidays to serve one of the state’s busiest lakes, Horsetooth Reservoir. Having a medical professional on the boat cut response times by 20-27 minutes, providing care sooner to the injured and ill.
- The Bicycle Emergency Response Team, or BERT, began servicing Fort Collins’ popular Old Town in late 2016 during busy nights and weekends. These EMTs provide medical services to areas less accessible to vehicles. In the first two weeks, EMTs answered 25 calls that may have otherwise been 911 calls that may have resulted in an ambulance transfer. Since EMTs can quickly access a scene, ambulances were needed only 6 times on 25 calls, reducing costs in the community. The team carries a complete line of medical and trauma equipment as well as an AED.
- UCHealth paramedics remotely monitor patients who may be high users of the Emergency Room to address issues a patient has before it becomes emergent, thereby reducing trips to the Emergency Room. The patients have blood pressure monitors, glucose monitors and scales that measure weight, all which are tracked electronically.
Community paramedics help provide patients with simple medication adjustments to help reduce a visit to the ER or readmission to the hospital. Paramedics also provide a home health visit to assess patients for fall risk, and provide resources for people to grow their support system, improve nutritional and financial help and other community needs.
Hospital to Home program in Colorado Springs
Through an innovative partnership between UCHealth Memorial Hospital and The Independence Center, patients like Steve Frost are home, sleeping in their own beds at night.
The partnership is one of the ways that UCHealth is partnering with community agencies to provide innovative ways to reduce health care costs, readmission rates and ease capacity issues in hospitals by making beds available for the acutely ill. Through the Hospital to Home program, created by the two agencies, patients – and the health care system – fare better
In the Spring of 2018, Steve Frost had an epileptic seizure while driving. He went to Memorial Hospital Central, spent three months there, got out, had another seizure a month later and was back in the hospital for three more months. During his second stay, squatters broke into his modest, one-bedroom trailer in Fountain and trashed the place. When a social worker checked to make sure the residence was safe, she found disaster. Frost, who was medically fit to leave the hospital, had nowhere to go.
To help Frost go home from the hospital, Mandi Strantz, transition coordinator with the Independence Center, stepped in to help repair the damage in Frost’s home. The partnership is paid by a $120,000 award from the Memorial Hospital Foundation. Hospital social workers call on The Independence Center when a patient is medically ready to go home, but can’t because of social determinants. The Independence Center provides case management and resources to improve living conditions that help to keep patients out of the hospital.
“This is a way that we can extend our care and serve the community,’’ said Joe Foecking, director of the inpatient rehabilitation care unit at Memorial Hospital Central. Foecking also serves as chairman of the board of The Independence Center. He presented the pilot program to leaders at Memorial, who saw how it would improve patients’ lives.
“This is a clever program, and shows how we’re seeking ways to help people and reduce costs at the same time,’’ Foecking said. “We are freeing up resources for other people in our community who are acutely ill and need a hospital bed, and we are accommodating individuals in a most humanitarian way. This lessens the cost of health care, serves the community and these individuals don’t want to be here in the hospital, they want to be home,’’ Foecking said.
In many cases, people would be sent to a skilled nursing or long-term care facility, escalating the cost of care.