Colorado is doing well to make out-of-pocket healthcare costs affordable and transparent, but does not have policies in place to reduce unnecessary provision of care, a new analysis of state healthcare policies found.

Altarum, a research and analytics consultancy, released data on Tuesday ranking the policies and healthcare outcomes of states on four metrics, including in the areas of reducing prices and extending coverage to all residents.

“In 2018, Colorado was in the middle third of states in terms of covering the uninsured, ranking 25 out of 50 states, plus D.C.,” the scorecard states, adding that Medicaid coverage for childless adults extends to 138% of the federal poverty line.

The scorecard also gave Colorado high marks for reducing Cesarean-section births for low-risk mothers and for having “strong price transparency rules”.

On the other hand, Altarum recommended that Colorado create an oversight entity for healthcare spending and use claims data to address the provision of unnecessary care.

The report only evaluated policies in place before Dec. 31, 2019. Colorado plans to develop a state-regulated “public option” for health insurance scheduled to begin in 2022.

The most common healthcare burdens were the price of drugs and the cost of medical bills, and Colorado is one of the priciest states in healthcare spending per person. The Polis administration has stated that it would like to curb surprise medical bills from out-of-network providers, on which the report found 13 states had adopted full protections.

“We intend to stop this practice of out-of-network surprise billing, so that consumers aren’t asked to pay outrageous bills,” the administration wrote in its “Roadmap to Saving People Money on Healthcare.”

One policy that Altarum recommended for all states was to expand health insurance for undocumented immigrants, 45% of whom lack coverage. “Barriers to coverage cause significant hardship for these families and harm public health,” the report advised.