Project Summary: Assist Family Planning Centers with Setting Rates
Category: Health Insurance Rate Setting
Background: Most family planning clinics are publicly funded and serve a high-need population. Good data can help them set appropriate rates for services and help these clinics secure more sustainable funding streams. Family planning services are proven to provide cost savings and play an important role in prevention of unplanned pregnancies.
Objective: To develop reasonable service rates so family planning clinics can establish sustainable funding streams (like Medicaid and private insurance revenue), while ensuring long-term access to quality reproductive health services for all Coloradans.
Data Analyzed: Medicaid allowable paid amounts for CPT codes commonly associated with reproductive health visits.
Results: The APCD data provided a point of reference for family planning clinics to set up contracts with private insurers, ensure that their sliding fee scales were in line with market value of the services, and help project future revenue.