Posted: March 4, 2015 at 11:29 am By: Erika. Category: Consumer Voice

Legislators in more than 30 states have proposed or are pursuing legislation to promote price transparency, with most efforts focused around publishing average or median prices for hospital services.1 Some states have already have price transparency policies in place.2 For example, using its all-payer claims database New Hampshire publishes information about total and out-of-pocket costs.

California requires hospitals to give patients cost estimates for the 25 most common outpatient procedures. The state’s Office of Statewide Health Planning and Development also runs a “Common Surgeries and Charges Comparison” site, which posts median charges per hospital stay for common, elective inpatient procedures—searchable by year, procedure, county, and city. Pending legislation would require California hospitals to publicly disclose all charges, including physician and laboratory fees, for certain procedures.

Texas requires providers to disclose price information to patients upon request.

Florida’s www.FloridaHealthFinder.gov enables consumers to view the range of prices charged for various procedures, alongside quality-of-care ratings, mortality rates, infection rates, and other measures for hospitals, surgery centers, nursing homes, and hospice centers in the state.

Massachusetts’ Health Care Quality and Cost Council is developing strategies to promote consumer engagement in seeking high-value care through promotion of medical homes and shared decision-making.

On a federal level, the Affordable Care Act requires hospitals to publish and annually update a list of standard charges for their services. Starting in 2014, the health insurance exchanges will require participating health plans to create Web sites or other communication tools to enable consumers to look up their expected out-of-pocket costs for specific services under the plans.

Three bills have been introduced in Congress to promote price transparency, including H.R. 4700: Transparency in All Health Care Pricing Act of 2010, which would require physicians, pharmacies, and insurers to publicly disclose the prices of the services and products they provide.

1 A. D. Sinaiko and M. B. Rosenthal, “Increased Price Transparency in Health Care—Challenges and Potential Effects,” New England Journal of Medicine, 2011 364(10):891–4.
2 See Table 1 available at: http://www.ncsl.org/issues-research/health/transparency-and-disclosure-health-costs.aspx#Table_1.

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