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More States Move Towards Transparency on Hospital Medical Fees

A roundup of some states activity in relation to healthcare price transparency:

  • Colorado – A new law (Transparency in Health Care Prices Act) – that took effect this month requires hospitals and doctors in Colorado to publicly post their self-pay rates for common treatments, which often refers to publishing them on websites.  Hospitals must post the self-pay prices for the 50 most common treatments for diagnosed illnesses and the 25 most common therapies that use “procedural” technology.  “Health care providers,” which means physicians in solo practice, a medical group, an independent practice association or professional corporation must post their prices for 15 common treatments, assuming they perform them for patients.
  • Nebraska: Previously Nebraska had been active in promoting price transparency, through passing the 2014 Health Care Transparency Act. The Act created an advisory committee to investigate the creation of an all-payer claims database, and facilitates the reporting of health care and health quality data, provides for the facilitation of value-based, cost-effective purchasing of health care services by public and private purchasers and consumers, and includes provisions regarding claims and eligibility standards. In addition, Nebraska patients have the ability to petition hospitals for a written estimate of average charges for health care services, which promotes transparency and facilitates price shopping. (Source: http://sourceonhealthcare.org/nebraska/)
  • New HampshireNH HealthCost was developed by the New Hampshire Insurance Department to improve the price transparency of health care services in New Hampshire.  The state has an all-payer claims database, the Comprehensive Health Care Information System, known as CHIS, which was established by state law. It now is a national leader in providing information to consumers on what selected healthcare services will cost.
  • Ohio – Ohio’s Healthcare Price Transparency Law stipulates that providers had to give patients a “good faith” estimate of what non-emergency services would cost individuals after insurance before they commenced treatment. But the law didn’t go into force on Jan. 1 as scheduled, facing opposition from the Ohio Hospital Association which filed a court injunction that is currently delaying enactment. (Source: Kaiser Health News)

Examples of State Health Price Information Disclosure Websites (source: National Conference of State Legislatures )

  • California: California’s Common Surgeries and Price Comparison (http://gis.oshpd.ca.gov/atlas/topics/financial/common_surgery) is a website allowing healthcare consumers to view and compare the price of 28 common elective inpatient procedures at hospitals across California.  Note: OSHPD decommissioned this Atlas website during the course of 2017).  The Department of Insurance, along with Consumer Reports and UCSF, produces the health care compare tool, called California Healthcare Compare.  It allows consumer to compare pricing and quality hospital to hospital.
  • Florida: Florida established a Website that enables consumers to obtain data on hospitals’ charges and readmission rates (http://www.floridahealthfinder.gov/CompareCare/SelectChoice.aspx).
  • Maryland: Maryland’s Health Care Commission provides consumers with an online hospital pricing guide (http://healthcarecost.mhcc.maryland.gov/) that lists, for each acute care hospital in Maryland, the number of cases, the average charge per case, and the average charge per day for the 15 most common diagnoses.
  • Oregon: Oregon’s website “Oregon Pricepoint,” is sponsored and maintained by the Oregon Association of Hospitals and Health Systems and allows health care consumers to receive basic, facility-specific information about services and charges.
  • New Jersey: New Jersey launched www.njhospitalpricecompare.com to help consumers make informed choices regarding price and quality of hospital services in New Jersey.
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