State progress on healthcare pricing transparency has slowed around the country, and some states have even stepped backward in providing clearer information to consumers about their healthcare costs.
The Catalyst for Payment Reform and the Health Care Incentives Improvement Institute have released their third annual report card on state price transparency laws, and once again, a majority of states receivedreceived a failing grade—45 to be exact. Two years ago, only 29 states received Fs.
The grades are based on legislation enacted the previous year. For that reason, they don't take into account a number of bills that are currently pending nationwide, adding more fuel to the debate about how much pricing information should be available to consumers.
The two biggest changes in this year's report card came from Massachusetts and New Hampshire. Massachusetts dropped from a B to an F when it enacted legislation that put the onus for price transparency on health plans and shifted it away from the government. As a result, the state shut down its MyHealthCareOptions website.
Meanwhile, after getting a failing grade last year, New Hampshire received the only A on the list for launching NH HealthCost, a consumer-focused price transparency website.
The other non-failing grades went to Colorado and Maine, which both received Bs, as well as Vermont and Virginia, which got Cs.
Still, momentum is building around price transparency, particularly as more people shoulder greater responsibility for co-pays and deductibles. States like Connecticut and New York are working on consumer-facing websites, and Maryland and Washington are similarly pushing forward on transparency initiatives, the report card notes.
About one-third of patients currently receive some degree of pricing information, whether from their health plan, healthcare provider or another source, said Gerry McCarthy, president of Transunion Healthcare. The clearinghouse's annual survey this year found that 80% of respondents said they valued price transparency on par with bedside manner in choosing a healthcare provider. Fifty-one percent even said they would change healthcare providers to receive more pricing transparency.
Pricing transparency has been a contentious issue among healthcare providers, who have been reluctant to disclose what is often viewed as proprietary information. And, even as more hospitals are publishing varying amounts of pricing data on their websites, the industry has still argued that most people aren't paying the listed prices for services because of contracts with their insurers or charity care discounts.
Moreover, there are questions about the extent to which patients can use price information to make decisions about care—especially for complex or emergency services, or in markets where there is limited competition.
Still, some consumers have begun to compare pricing information, especially for commodity services like imaging, laboratory work and elective surgical procedures, said Mark Grube, a managing director at consulting firm Kaufman Hall.
“There's lots of evidence that people are, in fact, shopping,” he said. “They're going online, they're doing research. Those providers that are higher-cost will have to prove their value.”