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Report card on price transparency gives most states a D or an F
January 12th, 2015
A brand new report card on healthcare price transparency for consumers gives 36 states a D or an F. Only 14 rated a C or better.
I first heard about this problem from one of my friends who is a nurse. She was looking for prices at different facilities for a colonoscopy. “Being a nurse, I thought this would be easy to access,” she said. She found out differently. “The hospitals tended to not have ready access to the charges,” she said. “One hospital accounting department told me that the person with that information was on vacation, and I’d have to wait a couple of weeks until she returned.” Huh?
This issue doesn’t exist overseas, said this nurse, who travels internationally on a frequent basis. “If you go to other countries, they have the price list of ALL procedures before they are done,” she said. “Another reason we have a faulty healthcare system: too many variations in prices.” This problem could be contributing to medical tourism, as patients fly to foreign countries for surgeries, she said.
The nurse was offered a half price “cash deal” to go to a surgery center if she agreed to pay upfront rather than submitting insurance paperwork. She had not met her deductible for the year, and because the procedure was outpatient, she would have had to pay the total cost of the colonoscopy. “So I went with the cash deal since I knew I would not meet the deductible on any other services by the end of the year,” she said.
Not every state scored poorly on the report card mentioned above. Two states (Massachusetts and New Hampshire) received an A for meeting several criteria, including: sharing information about the price of inpatient and outpatient services, sharing price information for doctors and hospitals, sharing data on a public website and in public reports, and allowing patients to request information prior to a hospital admission.
“Healthcare costs continue to rise, and consumers are increasingly being required to take on a growing share of those costs,” said Suzanne Delbanco, executive director of CPR, a non-profit employer coalition that co-sponsored the Report Card. “In this environment, it is only fair and logical to ensure that consumers have the information they need about quality and cost to make informed decisions about where to seek care. There is definitely a role for public policy and state legislation to support these efforts.”
The price for an identical procedure in the same city can vary by as much as 700%, said Francois de Brantes, executive director of HCI3 and report card co-sponsor. “It should be concerning to every lawmaker in the country that 18% of the US economy is shrouded in mystery,” de Brantes says. “Without price information, how can we possibly expect consumers to act in a value-conscious way? It is a duty of every state to protect its residents from unfair trade practices, and healthcare consumers are, for the most part, completely left to fend for themselves.”
Last fall several large national employers, labor, business coalitions and consumer groups issued a call to action to health plans and providers to share price information with consumers. Delbanco said, “We know there is more plans and providers can be doing. Laws and forthcoming legislation can provide powerful motivation to be more transparent. We hope this report card spurs states to act to help consumers further.”
So, at the risk of sounding like a parent, let’s work hard and get those grades up!