Source: Report Card on State Price Transparency Laws — July 2016Here’s how price transparency should work for a woman with a silver-level insurance plan in one state. Assume this consumer could go to any hospital and would choose based on the cost of care, meaning her out-of-pocket costs (deductible plus co-insurance). She could pay $5,079 at the highest-priced facility or $3,531 at the lowest-priced hospital. The difference between the two is $1,548.
Progress toward widespread price transparency comes slowly, according to the latest annual report from the Health Care Incentives Improvement Institute (HCI3) and the Catalyst for Payment Reform (CPR). In the “Report Card on State Price Transparency Laws – July 2016,” issued on Tuesday, the authors, Suzanne Delbanco, CPR’s executive director, and François de Brantes, HCI3’s executive director, explained what states are doing to give consumers the information they need to shop for care based on price.
As in past years, most states are doing poorly: 43 states earned an F grade for failing to meet even minimum standards. Last year, 45 states got an F. Continue reading
For those of us covering health insurance, one of the best sessions at Health Journalism 2016 addressed the challenging issue of how to find the true cost of health care.
Moderator Bruce Japsen, who writes about health care and health policy for Forbes, kept the focus on where reporters can look to uncover the actual cost of care in their communities.
That generated a terrific pro tip from panelist Chad Terhune of Kaiser Health News. Continue reading
Source: California Healthcare Compare and Consumer ReportsCalifornia Healthcare Compare provides price and quality data for hospitals and physicians in 18 regions of California.
California has embraced the Affordable Care Act in big way. It launched one of the first and most robust state-run health insurance exchanges, and expanded its Medicaid program (known as Medi-Cal) to enroll the uninsured.
As a result, the state’s uninsured rate dropped from 6.5 million residents in 2013 (which is 17.2 percent of the state’s population) to 4.8 million last year (12.4 percent), according to the U.S. Census Bureau. (See AHCJ’s coverage of the bureau’s latest data release here and here.) Continue reading
When writing about transparency in health care prices and quality, journalists should expose the myths that health care providers promote. That’s the advice Francois de Brantes gave during a session on price and quality transparency at Health Journalism 2015 last month.
The executive director of the Health Care Incentives Improvement Institute (HCI3), de Brantes (@Fdebrantes) said, “Call them on their bull sh–. Their arguments against price and quality transparency are bogus.”
Yet when state legislatures consider laws promoting the public reporting of health care prices and quality ratings, provider organizations often lobby against these laws. “What are they protecting?” he asked. “Doesn’t the public have a right to know?” Continue reading
Photo by Truthout.org via flickr.
Health insurers are taking incremental steps to release information on what they pay to health care providers. Each month, they reveal just a bit more.
This week, Aetna, Assurant Health, Humana and UnitedHealthcare released state and local cost information through the nonprofit Health Care Cost Institute (HCCI) on a consumer site called Guroo.com. The data show the costs for about 70 common health conditions and services and are based on claims from more than 40 million insured individuals, HCCI announced.
No other organization has made these data available, HCCI said. In that way, this release is significant. Or, as the Guroo site says of the data: “The biggest collection of cost information is now at your fingertips, so you know what care really costs.”
Well, not exactly. The data show what insurers paid. Or, as Jason Millman pointed out in The Washington Post, “The site doesn’t break down what a consumer pays for services versus what the insurer pays.” Continue reading
Here’s a resource for health care costs – and a creative journalistic model of crowdsourcing, data collection, mapping, reporting and blogging.
ClearHealthCosts.com was started by former New York Times reporter and editor Jeanne Pinder. She received start-up funding from foundations (Tow-Knight Center for Entrepreneurial Journalism at CUNY and others listed on the website) and ClearHealthCosts now has a team of reporters and data wranglers chipping away at some of the difficult questions that patients need answered: How much is this treatment going to cost me? Can I find a better price?
It’s about shedding light on a health care cost and payment system that, to use Pinder’s word, is “opaque.” Some of what they are doing is specific to a half-dozen cities; other projects are building out nationally.
The data collected by ClearHealthCosts focuses on elective or at least nonemergency procedures such as imaging, dental work, vasectomy, walk-in clinics, screening (mammograms and colonoscopy) and blood tests. Much of the data is crowdsourced, and focused on New York area, including northern New Jersey and other suburbs; the San Francisco and Los Angeles areas; and Houston, Dallas-Fort Worth, Austin and San Antonio in Texas.
A recent grant from the John S. and James L. Knight Foundation via its Prototype Fund will let ClearHealthCosts collaborate with KQED in San Francisco and KPCC/Southern California Public Radio in Los Angeles to crowdsource Califoria prices. Earlier, Pinder’s team did a crowdsourcing partnership with the Brian Lehrer Show at WNYC public radio in which hundreds of women shared mammogram payment information, and their thoughts. It led to a series of blog posts including here and here. Continue reading