Skip to main content
Sister Publication Links
  • ESG: THE NEW IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Digital Health
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Supply Chain
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE +
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Insurance
September 22, 2015 01:00 AM

California launches price transparency tool but lacks provider-specific data

Beth Kutscher
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    The California Department of Insurance has launched a tool for consumers to compare price and quality information for providers in their region.

    In doing so, California joins states such as Colorado, New Hampshire and Maine, which have sought to make price information more transparent. But concerns persist about the level of data available and whether consumers can use it to comparison-shop.

    The site, California Healthcare Compare, allows consumers to search for the average price of about 100 common medical procedures and conditions, including caesarian sections, knee replacement surgery or chest pain. The data includes the average price as well as the price range in a particular county, including the total amount paid to providers, the amount insurance pays and the amount that an insured patient would be expected to pay.

    Consumers also can search for procedures by hospital, which are rated for quality and patient experience on a five-point scale. The hospital search will bring up the average total price providers receive in that area, but not provider-specific data.

    The state received a $3.9 million grant from HHS and partnered with Consumer Reports and the University of California, San Francisco to build the platform.

    The proliferation of high-deductible plans has increased the need for transparency around price and quality, said Dave Jones, the state insurance commissioner.

    “Californians, until this moment, have really struggled to get price information,” he said. “Having price information really matters as consumers have to dig into their own pockets.”

    The data have confirmed one trend in the state: Providers in Northern California are paid as much as 50% to 100% more than those in the Southern California for the same service. But the site doesn't allow consumers to find out what a specific provider is paid for a service.

    For that level of granularity, California would need to establish an all-payer claims database similar to the ones in New Hampshire or Massachusetts, Jones acknowledged. “I'm hopeful that stakeholders will demand the information,” he said. “I think consumers will insist on it.”

    The price information comes from Truven Health Analytics, which supplied data from more than 10 million claims during 2010 to 2013.

    Yet the more immediate goal of the website was to give consumers information on how much providers are paid so that they can negotiate payments when they go out of network, said Doris Peter, director of the health ratings center at Consumer Reports.

    Momentum around price transparency has been building across the country, but questions remain about whether the current tools are useful. While a majority of consumers have tried to find price information, they're least likely to use a third-party website to do so.

    Instead, consumers are asking their friends, relatives and colleagues for information, according to a survey of about 2,000 people from Public Agenda and the Robert Wood Johnson Foundation. They're also asking at the point of care, seeking information from a receptionist or doctor's office staff. But only 17% of respondents have turned to a website not associated with their insurer.

    “They're asking people they know, which is normal,” said David Schleifer, senior research associate at Public Agenda, a not-for-profit research group. But it's unclear why they're skipping over third-party sources, he added. “It may mean that they don't know how to find reliable or trustworthy information.”

    Although 56% of respondents had sought price information, the survey found that most people were checking prices for just one provider. In follow-up interviews, a number of respondents said they either didn't have many choices in their area or they trusted their doctor and didn't want to go elsewhere.

    But a more pressing problem may be a lack of awareness.

    Less than half of respondents, or 43%, knew that some doctors charge more than others. “There's a very significant share of Americans who don't know that prices vary,” Schleifer said. Still, those people who did compare prices, saved money on medical care, he added.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    medicare-advantage-CMS-audits
    More MA insurer audits mean more scrutiny on providers
    medicare advantage directories
    Provider directories are a mess. CMS' plan to fix them has few fans
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Daily Finance Newsletter: Sign up to receive daily news and data that has a direct impact on the business and financing of healthcare.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Digital Health
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Supply Chain
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE +
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing