Low Value Care in Colorado
Colorado All Payer Claims Database, 2020
Trends
Impact In 2020 there were:
1 Million
All Payers
Low Value Care Services*
$134M
Opioids for acute back pain
$27.9 M $24.5 M
$14.2 M
Prostate Cancer Screening (PSA) $6.2 M Imaging tests for eye disease $5.9 M Coronary $5.8 M Angiography Annual Cardiac $4.8 M Screening
10.1%
Baselinen $4.2 M Preoperative Laboratory Studies n
Ft. Collins
9%
9.8%
Greeley
Boulder
Denver
10.7%
10.9%
10.3%
West
12.3%
12.1%
9.3%
Grand Junction
10.3%
East
Colorado Springs
9%
Pueblo
8.8%
8.8%
Payer Type Top Three Low Value Care Services by Payer, 2020 Low Value All Payer Total Care Service Spending Cen. catheters in stage III-V patients Use of two or more antipsychotics
Prostate cancer screening (PSA)
Verbioplasty $4.6 M
12.7%
9.6%
Opioids for acute back pain
$4.7 M Revascularizationn
Medicare Advantage
11.4%
The top 10 services accounted for 77% of total low value service spending.
Use of two or more antipsychotics
Medicare
Note: Medicare FFS only available through June 2020 12.3%
10.7%
of total spending was categorized as low value care.
Peripheral catheters in stage III-V CKD patients
Medicaid
Commercial
12.6% 12.5%
in spending. Or...
11%
Division of Insurance Region Variation (Avg. Cost per Low Value Care Service), All Payers
Percent of Spending Categorized as Low Value Care 2017-2020
Over
Resulting in
Geograhic Distribution
Annual EKGs of cardiac screening Routine general health checks
$27.9M $24.5M $14.2M
Commercial
✓
$6.8M $1.4M
Medicare
Medicare Advantage
$4.1M
$374K
$15.4M
✓
✓
✓
Medicaid
✓
✓
$9.6M
$9.8M
$3.4M
✓
✓
✓
$4.6M
$2M
$3.8M
$3.5M
$6.2M
$2.4M
$714.5K
$1.4M
$1.6M
$4.8M
$3.3M
$325K
$209K
$3.4M
✓
✓
$2.7M
✓
DOI Regional Cost Variation per Low Value Care Service
Grand Junction
$479K
$6.4K
$20.9K
$167
Boulder
$152
West
$151
Denver
$147
Greeley
$133 $126
Pueblo East
$736K
$167
$112
Colorado Springs Fort Collins
$122 $120 $112
Notes: Low Value Care services are those identified as Wasteful or Likely Wasteful. All Payer totals may not equal the sum across individual payers. Medicare FFS claims only available through June 2020.
For more information or to view the full Low Value Care in Colorado Report, visit us at: www.civhc.org