How Did MA Score on Health Transparency?
Saturday, March 23, 2013
Massachusetts was not one of the twenty-nine states that got a failing grade for transparency in health care, and was one of only two states that earned an “A.” New Hampshire was the only other to score a top grade.
The objective of this research was to determine how much pricing information each state makes accessible to the consumer.
“While no state has implemented laws that meet all of our criteria, we graded on a curve to acknowledge the states with the most advanced laws to date. We anticipate that this curve will shift as transparency becomes more of a priority nationally,” the report stated.
The report used many metrics to grade states, including the average charges, amount paid by insurers as well as consumers.
Scope of services covered under law was also measured and included all medical services, inpatient services only, and outpatient as well as services only or the most common inpatient and outpatient services. The report also based grades on providers affected by the law including: hospitals, physicians, and surgical centers.
“As health care costs continue to rise, consumers are increasingly being required to take on a growing share,” the report stated. “To underscore that point, the most recent survey by Mercer shows that close to two-thirds of all large employers offer a high deductible/high co-insurance health plan and that close to 20 percent of all commercially insured health plan members are enrolled in such plans.”
How Mass Stands Out
The grade breakdown issued in the report shows how easily this information is accessed in each state. Transparency levels are represented in tiers from least to most available – state only, upon request, report, website.
State statutes also set Mass. aside, including the state’s general law that states, “institutional providers and their parent organizations and any other affiliated entities, non-institutional providers and provider organizations” may legislate hospitals, surgical centers, or all providers including individual physicians.
Price information is also reported to the state under Mass law, and legislation exists to define price and charges.
“We hope the Report Card will inform advocates, lawmakers and policy experts about today’s best practices or what constitutes a top grade and, over time, generate improvements in public policies across the nation,” the report stated. “American consumers deserve to have as much information about the quality and price of their health care as they do about restaurants, cars, and household appliances.”
Across the Region
Grades “B”, “C” and “D” ranged from 30% of the criteria to 59%. And any state below that was flunked.
New Hampshire and the Commonwealth brought up the top in New England. Six states received a “B,” including Maine, as well as Minnesota, Wisconsin, Virginia, and Colorado.
Vermont was the only state in the area that received a “C,” which also went to Illinois, Iowa, Kentucky, Nevada, South Dakota, and Utah.
No New England states earned a “D,” with the rest of the area failing the joint report’s grading.
Acknowledging that much of the nation is just getting started in getting price transparency up to par with other markets, the groups said any state meeting 60% to 100% of its criteria got an “A.” Had the grading curve not been used, New Hampshire and the Bay State would have been the only states that passed.
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