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New Hampshire Price Transparency Website May Have Impact on Provider/Insurer Payment Negotiations

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Modern Healthcare writes of the New Hampshire price transparency experience which started over a decade ago, and the state, recently recognized as the nation’s transparency leader, offers lessons to other states that aren’t as far along.  Its experience suggests that publishing the rates insurers actually pay providers can have an impact on payment negotiations.  The price transparency initiative (NH Healthcost) also has encouraged new health plan benefit designs that are sending consumers to lower-cost care settings, and has prompted hospitals to offer patients lower-cost care settings.  While New Hampshire is a test case for price transparency, its experience is limited by a lack of hospital competition. Only two cities, Manchester and Nashua, have more than one hospital; the whole state has only about 30 hospitals and three major commercial insurers.

The state has an all-payer claims database, the Comprehensive Health Care Information System, (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. Based on claims data from CHIS, NH HealthCost gives consumers an estimate of what their health plan pays for a service and what their out-of-pocket cost would be. Colorado, Maine and Vermont have also created claims databases and are trying to let consumers look up actual prices. North Carolina recently began publishing cost data submitted by hospitals on 100 common inpatient services, 20 surgical procedures and 20 imaging procedures, including the actual prices paid by public and private insurers.

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