Study shows that a majority of Colorado hospitals are falling short of requirements around patient rights, access to discounts
The Colorado Health Care Initiative evaluated websites and caller response of 89 hospitals to determine compliance with the Hospital Discounted Care law
Nearly 60% of Colorado hospitals are failing to meet requirements set by a program created in 2022 to curb the cost of health care for low-income patients, according to a new report from the Colorado Consumer Health Initiative.
The Hospital Discounted Care law went into effect in September 2022, requiring that hospitals screen uninsured patients for eligibility for state-run health care programs. It also placed limits on what patients at or below 250% of the Federal Poverty guidelines can be billed for services at hospitals and emergency rooms as well as limits on the amount providers can be billed. The law also requires that the hospitals give patients a chance to apply for the program when they receive services at the hospital.
According to the Colorado Consumer Health Initiative, under this law, all hospitals in the state are required to:
- Inform patients of their rights
- Screen patients to see if they qualify for help paying their bills
- Offer discounts and affordable payment plans on hospital care to patients who qualify based on their income, regardless of documentation status
- Reduce the use of debt collectors by taking certain steps before sending an unpaid hospital bill to collections
For the report, the Colorado Consumer Health Initiative looked at websites and made phone calls to 89 facilities that are eligible for Hospital Discounted Care.
It found that while 100% of the hospitals mention the program and post the patient’s rights forms on their websites, only 58% of them met the full regulatory website requirements. This included not posting the required application, offering patients rights in both languages, linking to information on the program from the home page and more. Only 50% distinguished the program from other financial assistance options.
Support Local Journalism
In its phone call data, the study showed that out of 178 calls — one in English and one in Spanish to each hospital — only 11% had successful outcomes where the caller received helpful and accurate information about Hospital Discounted Care. This percentage was lower for calls in Spanish. The initiative also found that independent hospitals were more likely to have successful outcomes than health system-owned hospitals like CommonSpirit and UC Health.
In a statement, Kevin Massey, CommonSpirit’s communications manager for the mountain region, stated that CommonSpirit has been “deeply committed” to fully implementing the discounted care law. In 2024, CommonSpirit has completed 17,500 screenings for uninsured Colorado patients, he added.
Massey stated that CommonSpirit had been addressing some of the issues identified in Colorado Consumer Health Initiative’s report before its publication.
“However, we are dedicated to continued improvement and appreciate (Colorado Consumer Health Initiative) for identifying concerns in accessing the financial options available to consumers,” he added.
Twenty-nine percent of the calls demonstrated some noncompliance with the regulations.
Sophia Hennessy, the policy and research coordinator for Colorado Consumer Health Initiative, wrote in an email that the report not only showed that there were compliance issues, but also that there are significant challenges with accessibility and usability of the program.
“Meeting the bare minimum compliance does not equate to accessible information for consumer,” Hennessy wrote. “For instance, while hospitals must post the Patient’s Rights form in Spanish on their website, they are not required to have a Spanish translation option for their website. As a result, Spanish-only speakers have to navigate an English-only website in order to access information about (Hospital Discounted Care) in their preferred language.”
The need to be able to access this information is only growing more critical as the cost of health care rises, she added.
Hospital Discounted Care is administered by the state’s Department of Health Care Policy and Financing. As part of state’s enforcement, the department is required to conduct annual reporting and audits to ensure compliance with the law. Marc Williams, a spokesperson for the department said it is currently completing its first round of these audits. The results are expected in the spring.
With the department focused on compliance, Hennessy wrote that the study was also aimed at evaluating gaps between the intent of the law and implementation.
“What we were trying to see is how the law is working for the patients that are actually trying to find information about discounts and utilize them, and see what access looks like from their point of view,” Hennessy wrote. “Based on our interpretation of the law, we found that a significant amount of hospitals aren’t meeting the intent of the law.”
The Colorado Consumer Health Initiative report makes recommendations to hospitals and the state department to help bridge this gap. For hospitals, these include removing administrative barriers to information and screening for the program, proactively informing patients of the program, training staff members and more. For the department, this includes simplifying applications, creating a template for hospitals to use on their website and more.
While the state department was not engaged in the report’s creation, it was given an opportunity to provide feedback on the final report before publication, Williams said.
The department plans to review the recommendations in the report and will “make adjustments as warranted within the scope and requirements of the law,” he added.
Editor’s Note: This story has been updated from a previous version to include a statement from CommonSpirit.
