Report: 29 states failing at transparent healthcare pricing

More than half of U.S. states are failing at transparency when it comes to disclosing costs for healthcare services, according to Health Care Incentive Institute and Catalyst for Payment Reform’s March 18 report on state price transparency laws.

In all, 29 states received an F score for their failure to have any transparency laws, while only two states--Massachusetts and New Hampshire--scored an A for adequate transparency laws. States that followed with a B grade included Colorado, Maine, Minnesota, Virginia and Wisconsin (a complete list is in the final report).

“The U.S. healthcare industry is, by and large, completely opaque. As the number of consumers in high deductible/high co-insurance health insurance plans continues to grow, market opacity prevents consumer-patients from comparison shopping,” according to the report.

In some cases, the low grades reflect “gag clauses” among specific providers or payers that prevent them from disclosing the true costs of services rendered in the management of the patient.

Also, the report noted that transparency legislation varies widely state-by-state, with some requiring that prices be posted on a state website or printed in an annual report, or require participation in an all-payers claims database for their own analysis and reporting. Barring federal regulation and comprehensive legislation across all states that supports patients’ rights to understand and access prices for medical services, “we cannot expect a functional market for healthcare services to be developed.”

The report card culminated from extensive research into state statutes and enacted bills. Researchers looked at two elements--the varying levels of price information and the varying levels of public access to that information--to develop a continuum used in the scoring criteria.