The Catalyst for Payment Reform and the Health Care Incentives Improvement Institute have released their report card on state price transparency laws based on 2014 legislation, and the report shows little progress from the year prior.
For the report, the organizations used a 150-point scale, with 100 points available based on a state's price transparency laws and regulations.
If pricing information was only available to consumers from providers, the state could earn 50 points based upon a number of factors, including the pricing information that is available and how the pricing information is disclosed.
If pricing information was available to consumers from payers via an all-payer claims database, the state earned an automatic 50 points and was eligible for another 50 points based on the same factors that were considered if the information was only available directly from providers.
States could also earn 50 points based on legislated price transparency websites. For a state to earn the maximum amount of points in this category, the website must do all of the following:
- Estimate consumers out-of-pocket expenses
- Have quality and price side-by-side
- Offer provider comparisons
- Have clear language, no jargon
- Have a search function by provider/procedure/service/condition
- Have ease of navigation/layout
- Include a large number of services
- Include a large number of providers
- Include paid amounts (not just charge data)
- Have information that comes from a reliable source (extra points for all-payer claims directory)
- Provide confidence of estimate and current data
- Have data flowing to the site
Based on the rating criteria, New Hampshire was the only state to receive an "A" grade this year. Colorado and Maine received a "B" grade, and two states — Vermont and Virginia — received a "C" grade. The remaining 45 states earned an "F" in this year's report.
Most of the states' grades remained unchanged this year, with the exception of Colorado (from "C" to "B"), Massachusetts (from "B" to "F") and New Hampshire (from "F" to "A").
"Over the last several years, states have become more aware of the problems associated with a lack of price transparency," the report authors noted. "While legal barriers hindered initial efforts to promote price transparency, states can address many of these barriers though legislation and litigation."
The full 2015 report can be accessed here.