Massachusetts takes price transparency to next level

Massachusetts has become perhaps the first state to take the next step into price transparency, mandating health insurers to post the costs of a variety of medical procedures for their enrollees, Kaiser Health News has reported.

On Oct. 1, insurers had to begin posting prices on their websites for items ranging from an office visit to surgical procedures--a move Kaiser Health News described as "seismic" in terms of the power being bestowed onto consumers.

"This is a very big deal," Massachusetts Undersecretary for Consumer Affairs and Business Regulation Barbara Anthony told Kaiser Health News. "Let the light shine in on healthcare prices."

However, not everything is listed in the prices, such as fees for interpreting a test or facility fees charged by hospitals, which can sometimes run into the hundreds of dollars. And there is very little information available regarding the prices for many inpatient procedures. That's the type of item that can leave patients with thousands of dollars in out-of-pocket costs, and insufficient information prevents patients from making coherent buying decisions.

The posted prices also reflect wide price variations by facility--for example, a bone density test that costs $190 at Harvard Vanguard runs $445 at Brigham and Women's Hospital. Anthony told Kaiser Health News she expects that some higher-priced providers may cut their costs due to competitive pressures.

Nevertheless, the Massachusetts mandates put the Bay State light years ahead of most other states, the overwhelming majority of which receive failing grades for healthcare price transparency, and in some instances, charge vastly gyrating prices for basic services such as blood tests. And with the growing number of patients who have high-deductible health plans, more consumers will want to know how much procedures cost.

"As more and more members are faced with greater and greater cost share, this sort of information is really important," Bill Gerlach, director of member decision support at Blue Cross Blue Shield of Massachusetts, told Kaiser Health News.

To learn more:
- read the Kaiser Health News article

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