Two non-profit organizations, Catalyst for Payment Reform (CPR) and the Health Care Incentives Improvement Institute (HCI3) – have issued a new report card on state price transparency law. The report card takes a comprehensive look at state laws designed to give consumers basic information about the average or expected prices of common health care services and gives only 14 states a “C” or better.
Catalyst for Payment Reform is an independent, non-profit organization made up of large employers and other healthcare purchasers to support improvements in the way healthcare services are paid for. The Health Care Incentives Improvement Institute, Inc. is a non-profit umbrella organization for Bridges to Excellence, and PROMETHEUS Payment, which develops performance based payment and reward programs for health care providers.
Only Massachusetts and New Hampshire received “A” grades for transparency. They met several criteria, including: sharing information about the price of services for both inpatient and outpatient services; sharing price information for both doctors and hospitals; sharing data on a public website and in public reports; and allowing patients to request information prior to a hospital admission. 36 states, a full 72% of the nation met few if any of the criteria, and mostly got “D” or “F” grades.
The ratings are also notable for states like Nevada, which recently passed a package of laws designed to increase hospital transparency following an investigative reporting series by The Las Vegas Sun. Even with this legislation, Nevada only rated a “C” grade.
The majority of states have very basic laws requiring average charges to be made public, but charges do not reflect what consumers, employers, and health plans actually end up paying for care. In many cases, the information is only available upon request, placing a considerable burden on the consumer.
CPR has created comprehensive requirements for price transparency, and notes that some progress is happening at the private sector level, even while public sector agencies remain woefully inadequate. “Health care 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. “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.”