29 States Fail In Healthcare Price Transparency

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29 States Fail In Healthcare Price Transparency

Only 2 states earned an A for helping consumers learn true cost of care

March 18, 2013 | By Julie Bird

Nearly two-thirds of states--29--received a failing grade for their healthcare price transparency laws in a report released today by the Catalyst for Payment Reform. Another seven states squeezed out a D grade, according to the report compiled by a consortium including the Health Care Incentives Improvement Institute and large healthcare payers.

Only two states--Massachusetts and New Hampshire--received As for their price transparency laws. Colorado, Maine, Minnesota, Virginia and Wisconsin earned Bs, while Illinois, Iowa, Kentucky, Nevada, Utah, South Dakota and Vermont received Cs.

A foreword to the report noted that consumers are increasingly being asked to take on a larger share of their healthcare costs.
"But with recent studies showing us that the price for an identical procedure within a market can vary seven-fold with no demonstrable difference in quality, price transparency is more important than ever," it stated.

States can help consumers get better access to quality and price information through laws and policies promoting transparency, according to the report, but it showed few states are doing so.
The groups noted they were grading on a curve, so the standard for an A grade would shift as more states implemented a range of transparency initiatives.

States receiving failing grades have "practically no transparency requirements," noted a Kaiser Health News Capsules blog post. That leaves consumers little way to learn that, for example, prices for knee-replacement surgery can range from $15,000 to $100,000 at hospitals in the same California market, according to the post.

The report's grades include an assessment of whether states require hospitals to disclose the difference between hospital charges for service and what consumers actually pay through their insurers, KHN noted.

Meanwhile, a recent study that found wide ranges in hospital emergency department charges for common procedures suggested patients might curb nonemergency use of the ED if they knew costs up front. First, though, hospitals needed to be transparent with ED providers about the cost of care they were about to provide, the researchers said.

Another study found that only about half of 100 hospitals contacted nationwide could provide a price quote for hip surgery--and those prices ranged from $11,100 to $125,798. Study authors attributed the wide price variance to the different payment rates hospitals agree to with private insurers, Medicare and Medicaid.

To learn more:
- download the report (.pdf)
- read the KHN Capsules blog post

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Thank You Fierce Healthcare and Ms Bird