State initiatives to create publicly available cost information have lagged behind health insurer and other private members-only efforts, hampering broader investigations into pricing differences, according to researchers and benefits experts.
Massachusetts and New Hampshire were the only states to garner the highest “A” rating earlier this year in a report card on public tools issued by two nonprofit organizations, the Catalyst for Payment Reform and the Health Care Incentives Improvement Institute. Nearly three-fourths of states received failing marks for their lack of detailed and easily accessible cost information.
New Hampshire is notable for developing an online site more than five years ago after legislation required all insurance providers to submit claims data to the state.
Consumers can navigate separate links, depending upon if they have insurance and even calculate out-of-pocket payment based on their own coverage specifics.
In Maine, employers and consumers also have access to data through the Maine Health Data Organization. But the number of services is limited and the information is not current, with the most recent data from 2010, said Tom Hopkins, director of compensation and benefits at the University of Maine System in Bangor. Hopkins is one of the employers in Maine who is waiting on a cost-related rollout from the Maine Health Management Coalition.
The coalition provides some data on the quality of doctors and hospitals on its website, getbettermaine.org. Now it’s working on measurements to reflect cost.
Hopkins already sees negotiating potential, for example if one hospital is consistently more expensive than another. “It provides us with an opportunity to say, ‘You need to get this under control. Because if you don’t, we will.’ ”