Transparency in Action: State Reports Detail Hospital Finances, Community Investment, and Care Improvements

What the data shows: Hospital finances stabilizing ahead of challenges posed by federal Medicaid cuts

FOR IMMEDIATE RELEASE

February 13, 2026

Media Contact
Marc Williams
Department of Health Care Policy & Financing
720-626-0801 (Cell)

Denver, CO - The Colorado Department of Health Care Policy & Financing (HCPF) recently released three annual reports that, when considered together, provide a clear, data-driven picture of the financial health of Colorado hospitals and the benefits delivered to communities across the state. These reports - the Hospital Transparency Report, the Hospital Community Benefit Accountability Report, and the CHASE Annual Report - provide data-driven facts and policy-relevant insights into a complex health care system. By promoting greater transparency in hospital financial practices, reimbursement structures, and health outcomes, HCPF aims to help control costs, identify and address emerging challenges earlier, and pivot as needed to support more effective policy decisions that improve health care access, affordability and outcomes for all Coloradans.

"Going forward, HCPF's nationally leading hospital transparency reports will better enable Colorado to establish the baseline, propel sustainability strategy and illuminate the fiscal impacts on hospitals caused by Congress' H.R.1," said Nancy Dolson, HCPF's Budget Director. "Without intervention, H.R.1 will have devastating impacts on low margin, low reserve, and rural hospitals."

Key findings from the reports include:

• Hospital finances stabilized following the pandemic. After the COVID-19 public health emergency and its unwind, hospitals' financial positions have largely steadied, with a growing number of hospitals showing healthy operating margins. Some rural hospitals continue to struggle, and the state will continue to closely monitor these trends as H.R. 1 cuts are implemented in the coming years.
• A mixed bag of profits. A majority of hospitals reported total profit margins above 3 percent, with several large systems generating substantially higher margins-including hospitals that absorbed the largest increases in uncompensated care. Seventy-four percent of hospitals had a positive total profit margin. Over the last few years, there has been a fluctuating number of hospitals with a negative total margin (losses), including 13 hospitals in 2020, 11 in 2021, 40 in 2022, 32 in 2023, and 22 hospitals in 2024. Approximately 26.2% of all Colorado hospitals are running a negative total profit margin, and a majority of those are CAH or rural hospitals.
• Nonprofit hospitals are increasing investments in their communities. In 2023, nonprofit hospitals reported $1.44 billion invested in community benefits. This is an 18% increase from the previous year, representing 8.2% of net patient revenue reinvested in Colorado communities. However, 62% of community investments are going into provider education, research, and training, which is not fully aligned with where communities have indicated that they want those dollars to go, ie: initiatives that better meet the community's behavioral health needs, which 85% of all reporting hospitals' communities identified as a priority yet one of the lowest categories in terms of spending.
• Targeted Medicaid investments are strengthening rural hospitals. Through the work of the Colorado Healthcare Affordability and Sustainability Enterprise (CHASE) Board, administered by HCPF, Colorado is working towards maximizing federal matching funds. As a result, Health First Colorado (Colorado's Medicaid program) now reimburses 69% of rural hospitals above cost, up from 44% in 2020 -a higher proportion of cost coverage than commercial insurers provide to the same rural hospitals. With CHASE supplemental payments, Colorado Medicaid is paying 80 cents on the dollar of hospital costs, greater than Medicare, which is paying 72 cents on the dollar of hospital costs.
• The Hospital Transformation Program (HTP) has delivered meaningful results impacting both patient health outcomes and affordability. Since launching in 2021:
  • Pediatric depression screenings increased by 492%, with approximately 25,000 children screened statewide last year.
  • Postpartum depression screenings increased by 1,615%, resulting in more than 20,000 mothers screened and referred for care when needed.
  • Social needs screenings increased by 279%, connecting 58,000 Medicaid members with resources related to housing instability, domestic violence, and other needs.
  • Hospitals providing medication and treatment to patients in active opioid withdrawal in the emergency departments improved by over 75%.
  • The provision of Brief Intervention and Referral to Treatment after patients are screened positive for substance use in the ED has increased 338%.
  • Hospitals have improved their scheduling of follow-up appointments at discharge by over 50%.
  • Pediatric hospitals are performing exceptionally at reducing low-value, high cost services for children with bronchiolitis.
  • The strong focus on minimizing readmissions has helped CO maintain readmission rates around 9%; well below the national Medicaid average of around 13.6% ¹

"Hospitals represent the largest component of health care costs nationally and here in Colorado. Since their inception, Colorado's hospital transparency reports have illuminated opportunities thereby enabling hospitals to course correct, while fueling Colorado's fact-based health care policy, and driving hospital affordability metrics to the betterment of Coloradans, employers, and taxpayers," said HCPF Executive Director, Kim Bimestefer.

Colorado's Cost, Price and Profit National Ranking (highest to lowest)

"Colorado is leveraging its state legislative authority and expertise to inform the public about hospital finance and operations," said Dr. Ge Bai, PhD, CPA, Johns Hopkins Bloomberg School of Public Health. "Hospital affordability has been largely unaddressed at the federal level, and Colorado's efforts suggest that states are increasingly prepared to take an active role in deploying their own tools to tackle it."

"The annual hospital analysis published by the Colorado Department of Health Care Policy and Financing is especially valuable to my work studying provider and payer markets because of the useful way it weaves together financial data from Medicare cost reports and financial statements with narratives on capital investments, acquisition of physician practices and other significant developments in the state," said Allan Baumgarten, a Minneapolis-based analyst of health care markets, finance and policy and the author of Colorado Health Market Review.

On February 11th, HCPF hosted a webinar to share key findings from these reports, provided updates on the Rural Health Transformation Program, and presented perspectives on hospital impacts caused by H.R.1 and other changing federal policies. The webinar included robust discussions with CEOs from four Colorado hospitals:

• Dr. Donna Lynne, CEO Denver Health
• Kevin Stansbury, CEO Lincoln Community Hospital
• Margo Karsten, CEO Banner Health
• Dr. Robert Vissers, M.D. CEO Boulder Community Health.

HCPF welcomes ongoing conversation with policymakers, providers, and the public about the findings in these reports and their implications. HCPF deeply appreciates the collaboration with our stakeholders and hospital partners as we work in partnership to navigate the difficult landscape ahead.

Visit the Hospital Reports Hub for more information.

¹ Internet Citation: Statistical Brief #304. Healthcare Cost and Utilization Project (HCUP). September 2023. Agency for Healthcare Research and Quality, Rockville, MD. hcup-us.ahrq.gov/reports/statbriefs/sb304-readmissions-2016-2020.jsp

About the Colorado Department of Health Care Policy & Financing: The Department administers Health First Colorado (Colorado's Medicaid program), Child Health Plan Plus, and other programs for Coloradans who qualify. These health care programs now cover about one in four Coloradans. For more information about the Department, please visit hcpf.colorado.gov.