Healthcare Transparency – A System in Crisis

Healthcare Transparency – A System in Crisis
by Larry Sherman

The Federal Government passed the Hospital Price Transparency and Disclosure Act in 2013 mandating that all 50 states put laws and regulations in place that made it easy for consumers to get accurate up to date information on healthcare pricing, so they would have a relatively accurate assessment of what their out of pocket expenses might be when they required healthcare involving hospital procedures or stays.  The law mandated that these programs be in place and clearly available by 2015.

To date, 45 of 50 states have an “F” with regards to enacting laws and regulations regarding Healthcare Transparency effectively.

States are slowly enacting laws on healthcare price transparency, but consumers lack adequate access to meaningful price information in most of them.

The only state with healthcare price transparency laws in place that effectively enable consumers to ﬁnd the cost of medical procedures before selecting a hospital is New Hampshire

The tiny New England state was the only one to receive an A for transparency on the report card released in early July by the nonprofit organizations Catalyst for Payment Reform and the Health Care Incentives Improvement Institute.

Meanwhile, neighboring Massachusetts, a medical mecca, plummeted from a B last year to an F. It has plenty of company at the bottom; 45 states ﬂunked.

The only other states that passed were Colorado and Maine, which received Bs, and Vermont and Virginia, which received Cs.

The report card reviewed “whether states had passed laws or regulations requiring healthcare price information be made public and examined how well those laws were being put into action by providing residents with access to meaningful price information through public web sites and the use of all-payer claims databases (APCDs) as data sources for those sites.”

CarePayUSA’s Insurance Verification Tool is a solution for hospitals and physician offices to comply with the mandate regardless of when the state governments get around to it.