March 31, 2014

The report cards are out, and it looks like an Epic Fail for 45 out of 50 states on making standard healthcare pricing information readily available for their consumers. As pressure from the regulations of the Affordable Care Act heat up and many states enact legislation for better public reporting of pricing information, states are being graded on their performance.

In their Report Card on State Transparency Laws – 2014, The Health Care Incentives Improvement Institute (HCI3) didn’t pull any punches or offer any curves in the grading methodology on how well states were providing consumers with meaningful information about the price of healthcare.

With forty five failing grades, three Cs (Vermont, Virginia and Colorado) and only two Bs (Maine and Massachusetts) – it seems the transparency laws have not yet begun to accomplish their goals.

“The US health care industry is, by and large, completely opaque. As the number of consumers in high deductible/high co-insurance health insurance plans continues to grow, market opacity prevents consumer-patients from comparison-shopping,” HCI3 explains on their website. “And since fear of market loss is a significant concern for many providers, there has been a tendency to block attempts at greater transparency.”

According to HCI3, the dynamics of transparency legislation varies by state as some require pricing to be posted on a state website or published in an annual report; while others require information to be published via claims databases and reports citing quality and cost of care information by specific provider.

So what are Maine and Massachusetts doing differently?  It seems the only difference is that they are actually enforcing requirements for Providers to report accurate pricing data to their websites (Maine’s Website & Massachusetts’ Website). Although a visit to each website leaves much to be desired in gathering any kind of accurate pricing information.

The HCI3 report cites statistics from a 2008 Kaiser Family Foundation report showing that 64 percent of consumers have difficulty finding information on cost comparisons and 79 percent expressing they would like access to a website that compares the total cost of medical services.

This staggering failure to follow through with legislation raises questions as to why so many states are falling short. Is it a matter of providers blocking attempts to greater transparency as accused? Or is it simply a matter of ineffective planning and execution at the state level, in the same way we have seen with implementation of many insurance exchanges? Or a combination of both?

Will there ever be true, accurate price transparency in the American healthcare industry? Share your thoughts below!


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