Kansas gets flunking grade on report looking at health care price transparency laws

03/21/2013 7:02 AM

08/08/2014 10:15 AM

The state of Kansas received an “F” on a recent report card evaluating state price transparency laws by the nonprofit Health Care Incentives Improvement Institute and the Catalyst for Payment Reform.

The report card graded states on a weighted point system that looked at the laws that were in place to require publication of pricing information, including the online posting of such information, and the ability of patients to request pricing before receiving services.

The organizations are advocating for further dissemination of information about insurance companies’ reimbursements for services to providers, as well as what costs are coming directly from patients.

Only two states – Massachusetts and New Hampshire – received an “A,” and 14 states received a “C” or better.

Janet Hamous, executive director of the Wichita Business Coalition on Health Care, said she isn’t surprised about the grade and added that price transparency was among the issues on which the coalition has been working.

“Our hope is that with more transparency, people could make good decisions about where to go for treatment,” Hamous said.

“I think there is some reluctance on the part of some insurers or health plans to share information because others could back into what their discounts were. Everybody’s worried competitors might have access to (proprietary) information.”

Hamous said many factors influence the actual price of care, including whether a person has insurance or other discounts.

“What a patient ends up paying is often different than the actual cost,” she said. “If it’s just the charge information (that’s required to be reported), it doesn’t tell us a whole lot.”

Hamous noted that the states with the highest grades appeared to have more legislation on cost reporting.

“There has been specific thinking around how does this get configured, how does the data get gathered and what happens with it after it’s submitted,” she said. “Maybe we need to look at the legislation we have now and see if it’s really giving us what we need.”

Bob Hanson, director of communications for the Kansas Insurance Department, said the department will study the findings from a regulatory standpoint, but that will take some time.

Francois de Brantes, executive director for the Health Care Incentives Improvement Institute, provided an e-mailed statement about Kansas’ grade, noting that “for price information to be meaningful and accessible for consumers, a state needs to have that information readily available, and a public website is always ideal.”

“But more importantly, consumers need to know what is actually paid for health services – not just what facilities charge. What’s actually paid is a much more realistic number, helping consumers understand and estimate their own costs. Unfortunately, Kansas fails on both accounts.”

But Cindy Samuelson, Kansas Hospital Association vice president of member services and public relations, says the report card doesn’t give the whole picture of transparency.

“This specific report card doesn’t really assess the presence of transparency on a voluntary effort … it doesn’t have much value just looking at mandated laws,” Samuelson said.

“All (KHA) members I’ve talked to have put forth practices to be transparent and to help residents and communities to understand price,” she said. “There have been a lot of voluntary efforts in this vein.”

The Health Care Incentives Improvement Institute is a nonprofit organization based in Newton, Conn. The organization is primarily funded by the Robert Wood Johnson Foundation and the Colorado Health Foundation.

Catalyst for Payment Reform is a nonprofit organization that works “on behalf of large employers and other health care purchasers to catalyze improvements in how we pay for health services and promote higher-value care in the U.S.,” according to its website. Its members include 3M, AT&T, Boeing, Capital One, eBay, GE, Verizon and Wal-Mart.

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