Three states, two different price transparency experiences

Massachusetts is one of the first states in the nation to pass a price transparency law for consumers, but a recent test drive of the legislation is far from consumer friendly, Kaiser Health News reported.

The Bay State launched its transparency initiative last month, tying it to an overall price cap for healthcare delivery.

According to KHN, the law in the Bay State requires insurers to tell their policyholders how much specific procedures cost on request. But for the moment that requires policyholders to call a customer service representative and fill out a form that takes at least 20 minutes. If consumers wants to compare prices from various providers, they have to fill out a form for each facility.

"This doesn't feel very much like shopping," the KHN reporter observed. "The point of this new requirement is to help patients make smarter choices so that they start behaving more like consumers of health care. Insurers aren't thinking that way."

Altogether, it took two days of back-and-forth communications with officials at Blue Cross Blue Shield of Massachusetts to determine that it would cost $147 for an x-ray as part of follow-up care to a back injury.

"Healthcare is very complex and so it's difficult to make things simple, straightforward and precise," Derek Abruzzese, the vice president for strategy and product development at Tufts Health Plan, told KHN.

Price transparency efforts in other states appear to be more centralized, and with more of the burden on the provider rather than the payer. In New Hampshire and North Carolina--which also recently passed price transparency laws--providers would have to post or give a list of the prices for the most commonly utilized procedures to patients.

Meanwhile, KHN reported, other entities in Massachusetts, such as Harvard Pilgrim Health Care, are trying to develop a new spreadsheet that would quickly provide a range of prices for a specific procedure and make the shopping process much easier for patients.

To learn more:
- read the KHN article

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