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Price transparency a struggle, even among states which offer option for price comparison

Few provide adequate cost information for the most common procedures; data is often outdated, report says.

Beth Jones Sanborn, Managing Editor

New Hampshire's price transparency website.New Hampshire's price transparency website.

Even for states that have managed to institute some kind of method for consumers to compare prices for healthcare services, patients have few options for finding current pricing on common procedures. That's what a study from the nonprofit advocacy group Public Citizen shows.

The major findings of the study paint a rather dim picture. Only six states, specifically California, Colorado, Maine, New Hampshire, Virginia, and West Virginia, provide some way for consumers to compare prices.  Of those states, few provide adequate cost information for the most common procedures.

Study authors performed a sort of "patient road test", looking at five common tests or procedures a consumer might want to shop around for. Those procedures were colonoscopy, computerized tomography scan of the head, hernia repair, knee replacement and magnetic resonance imaging of the brain. For some states, the pricing data centered on one geographic area.

[Also: Price transparency websites need to be simple, help patients interpret the data, expert says]

Authors cited research from the CDC that showed these procedures were very frequently sought, and would paint a fair picture of how a patient could better understand their out-of-pocket expenses.

Results showed, however, that even the six states that offer comparison shopping websites, consumers still have trouble getting access to cost data for common procedures.

Only one website, that of New Hampshire, provided cost estimates for all five procedures used as case studies in this report, splitting the information for the insured and uninsured. Colorado's site provided information, although reasonably detailed, only for knee replacement estimates. California's site only showed information for colonoscopies and knee replacements.

Maine left out hernia repair information and Virginia had no information on MRIs. West Virginia showed no information for any of the procedures used as case studies. "Overall, the website is difficult to use. Many patients know the medical tests they need for their treatment yet not the category of procedures those tests fall under. That understanding is required for a patient to use this website to compare costs," authors wrote about the West Virginia site.

[Also: 43 states flunk when it comes to healthcare price transparency, groups say]

Also, results showed that most of the data captured in these websites are outdated, may not reflect current prices, making the information less useful. For privately insured Coloradans, claims data from 2012 is the most current information available, the report said.

Finally, West Virginia offers estimated charges from hospitals. Charges are do not necessarily tell a patient what they will pay in the end.

"The website produces cost results that it claims could not be the final cost of what a West Virginia patient should expect to pay," the report said.

To date, 19 states have passed legislation calling for the creation of databases that capture and track payments on behalf of patients by insurers or health care providers, but  many of these states' efforts include no plans to make information from the databases readily available for consumers.

[Also: Offering price transparency tools does not equal lower healthcare spending, JAMA study says]

This report comes on the heels of  the 2016 Report Card on State Price Transparency Laws, which is prepared by the Health Care Incentives Improvement Institute and Catalyst for Payment Reform, two independent health policy groups. According to the Report Card, all but seven states failed at providing some means of price transparency to consumers, and only three states receiving high marks. New Hampshire, Colorado and Maine each received an A due to the increased quality of their reporting and transparency websites. All three of these states appear in the Public Citizen report as well for providing some means of shopping around for consumers. Oregon received the only B in 2016, up from an F last year because of its sustained efforts to improve. Vermont and Virginia a scored C's this year.

Judith Hibbard, a Professor of Health Policy at the University of Oregon, said in order to be effective transparency websites need to do simplify sites for users and reduce the burden of processing information, saying  if they are given too much info to consider, or if that data is poorly organized, the patient could become overwhelmed.

She also stressed the importance of interpreting the information for the data, like highlighting which prices are fair or not so fair, and where procedures are more expensive. Finally, if quality information is coupled with price you can highlight "best value options," she said. This is best done by showing the price and quality information along with the high-value designation. Organizing the information that way allows users to see the reason for the designation.

Twitter: @BethJSanborn

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