Clear As Mud: State Laws Governing Health Care Costs Lack Transparency

Posted by Dorkina Myrick, M.D., Ph.D.

Image Credit: istockphoto.com

Wide variability in prices for routine medical services may be contributing to rising health care costs. The Catalyst for Payment Reform, a non-profit advocacy organization for purchasers of health care, issued a “Report Card on Price Transparency Laws.” State laws regulating the dissemination of health care cost information to patients and their families were studied, and scoring criteria were assigned based upon a range of pricing, health care services rendered, and health care providers impacted. (1)

The “Report Card” charted a 5-category weighted metric for assessing efficacy in sharing price information with consumers. The categories and weighted point assignments were:
(1) “Provision for publishing a report to the state only” (10 points),
(2) “Ability for patient to request pricing information prior to the rendering of services” (20 points),
(3) “Provision for publishing a public report on pricing information” (20 points),
(4) “Provision for posting pricing information on a public website”(50 points)(1)

Several states received failing grades for either not providing pricing information to health care consumers or for providing inadequate information. Alaska, Arizona, Delaware, Maryland, and New York were among 29 states that received a grade of “F”. Only two states, Massachusetts and New Hampshire, received “A” grades. (1, 2)

What does this mean for health care consumers? Perhaps consumers should be more proactive about obtaining the best available health care services for their money. Patients must be vigilant about questionable costs on their health care bills. Comparison shopping prior to obtaining health care services might not be a bad idea, either. But what about the chronically ill, mentally impaired, and the elderly who are unable to advocate for their health care needs? Who will be the watchdog for these individuals? In any case, the scarcity of information on health care pricing to the average patient could make health consumer self-advocacy daunting at the very least.

I am not certain how the “Report Card” information will be used to initiate change (or IF the information will be used to initiate change). However, at least awareness is raised, and increased awareness may lead to a sense of urgency for a different way of conducting health care business.

Image Credit: istockphoto.com

Blog Community:  What do you think about the lack of transparency in health care costs?  How has this lack of transparency affected your medical practice? As a patient, how has the lack of transparency affected you?

References:
1. “Report Card on State Price Transparency Laws.” Health Care Improvement Incentives Institute. Catalyst for Payment Reform. (Website Attachment, 1.1 MB) March 18, 2013. http://www.hci3.org/content/report-card-state-price-transparency-laws. Retrieved March 19, 2013.
2. Mitchell, Russ. “29 States Get “F” for Price Transparency Laws.” Kaiser Health News. March 18, 2013. Website. http://capsules.kaiserhealthnews.org/index.php/2013/03/29-states-get-f-for-price-transparency-laws/?cid=xrs_rss-nd%3C. Retrieved March 19, 2013.