States Fail the Grade on Health Care Price Transparency

Most states aren't providing health care price information in an accessible way, despite the existence of disclosure laws in many states.
by | March 25, 2014 AT 4:00 PM

Despite the growing number of laws that require publicly available health care pricing for consumers, most states fail the test of transparency, according to a new report from the Health Care Incentives Improvement Institute (HCI3).

Even among states with strong laws requiring price information from all payers, that data is often inaccessible to the public, the nonprofit research group found. This year’s rankings focused more on whether states have All-Payer Claims Databases (APCD), which pool together price information from all commercial and public insurers in a state. At this point, 11 states have an APCD, five are currently implementing an APCD and another 21 states have shown a "strong interest" in creating one, according to the All-Payer Claims Database Council, a group of government, private and academic players that provide expertise on the subject.

The price information all-payer claims databases collect can be displayed in a web format, allowing consumers to search for the price of a particular procedure with a particular doctor or hospital. The Incentives Improvement Institute views those databases as superior to laws requiring public release of information only from doctors, who generally only have to report inpatient hospital costs, which represent only a portion of what consumers pay for a procedure.

HCI3 rated states on a scale of 150 points by the strength of their laws and the existence of a website to publicly access price information for health procedures. The strength of a state’s score came down to the scope of reporting requirements, the level of public access and the availability of a website for consumers.

Given those standards, not a single state scored an “A.” Even New Hampshire, which previously received an “A,” fell to an “F” this year because its website has been down for an extended period of time. The highest scoring states were Maine and Massachusetts, with each earning a “B.” Colorado, Vermont and Virginia tied for second place with a “C.” The rest of the states failed.

Maine and Massachusetts set themselves apart with requirements for both health care facilities and individual medical professionals to provide data to a website. They also require information on the full amount of money paid for a procedure, not just charges for individual services.

States like North Carolina illustrate the problem faced by many others. In 2013, North Carolina passed a law requiring hospitals to share price information for common procedures on a new public website, but none of that data is yet available online. South Carolina signaled its intention to publish prices as well, but that information still remains largely inaccessible to the general public. Many other states require some form of disclosure, whether from doctors or insurers, but not both, not in a publicly accessible form and not in a way that accounts for all costs.

For the full report, see here.