How 4 States are Tackling Health Care Price Transparency

In recent years, insurers, state governments, employers and other entities have been trying to make health care price information more easily available.

With out-of-pocket medical costs continuing to rise in the form of high deductibles and insurance premiums, as well as copayments and even coinsurance, many Americans are feeling the squeeze. There is no quick fix, as the hastily introduced and quickly withdrawn American Health Care Act Bill showed, but potential solutions do exist that can help individuals and families obtain more affordable health care.

In recent years, insurers, state governments, employers and other entities have been trying to make health care price information more easily available. The belief is that with increased price transparency, Americans will be more aware of how much their medical care costs, leading them to “shop around” to save money. In 2015, Public Agenda conducted the first nationally representative survey of how Americans seek and use health care price information. Since then, what has been done to make health care price information more transparent? And are these initiatives effective?

New Hampshire was one of three states that received a grade of “A” for its price transparency laws from Catalyst for Payment Reform in 2016. Health insurers in New Hampshire must disclose price information to their members. The state also runs a free website providing price information that is specific to each resident’s insurer, deductible size and coinsurance.

Florida, on the other hand, was one of 43 states that received a grade of “F.” But the state passed price transparency legislation in 2016. Just this year, the state selected a vendor to create a more robust online price information tool and began implementing an all-payer claims database—a crucial building block of price transparency efforts.

Also receiving a grade of “F” for its price transparency laws in 2016 was Texas. There has been little recent price transparency legislation in Texas, according to the National Conference of State Legislatures, which documents state actions in health and other policy areas. The state runs a website that aggregates some types of financial data from insurers, but it does not provide Texans with information about how much they have to pay out of pocket for specific services or providers. Texas does not currently have an all-payer claims database but is reportedly considering whether and how to develop one.

New York also received a grade of “F.” The state is, however, planning to create an online platform to disseminate price and quality information to its residents based on an all-payer database.

So what is (or isn’t) working?

On April 6, Public Agenda will release new findings based on an updated nationally representative survey and on representative surveys in New York State, Texas, Florida and New Hampshire, all conducted in 2016. This research, funded by the Robert Wood Johnson Foundation and the New York State Health Foundation, will shed new light on how Americans are finding and using health care price information, and on how people use price transparency in New York State, Texas, Florida and New Hampshire.

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New York

Submitted by: Gary Diehl on Sunday, April 2nd, 2017

New York got an 'F' ? Wow. I got health insurance through the NY State of Health for the 1st year of Obamacare. I had no trouble comparing plans, prices, etc. Like all of the Obamacare web sites, it was a little shaky the first week or two, but that leveled out. I don't know if the web site has gone downhill since then. After the 1st year, I was happy with the insurance company that we selected (MVP) and since then, we get the insurance directly from MVP.

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