A new report gives Georgia and 28 other states an “F’’ grade in providing or requiring adequate information for consumers on the price of medical services.
The report card, released this week, gives only two states an “A’’ on price transparency – New Hampshire and Massachusetts. All the Southeastern states received failing grades except for Kentucky, which got a “C,” and Florida and Louisiana, which got a “D.”
The grades were produced in a joint effort by the Catalyst for Payment Reform, a group of employers such as Atlanta-based Home Depot, General Electric, Walmart and AT&T, and the Health Care Incentives Improvement Institute (HCI3), an organization seeking to improve health care quality and promote payment reform.
“Health care is the only industry where the price [of medical services] is opaque,’’ said Elizabeth Bailey of the HCI3, in an interview Tuesday with Georgia Health News.
“If you want a new car, you have access to [information] on prices and features,’’ Bailey said. “As a patient, I don’t really have access to that information.’’
Information about prices of medical services is more important than ever. An increasing number of patients have high-deductible health insurance policies, so they risk having to pay large sums out of their pockets if they need major care.
Nearly two-thirds of large employers offer a high deductible/high co-insurance health plan, and nearly 20 percent of all privately insured health plan members are enrolled in such plans, the report said.
Prices for a single medical procedure can vary by thousands of dollars in a given market.
For example, prices for knee replacement surgery in the same California market can range from $15,000 to more than $100,000, depending on the hospital, with no discernible difference in quality, Kaiser Health News reported.
The report’s grades reflect the quality and scope of the pricing data that states require and how well they disseminate this information to the public.
Some price information is available in Georgia through major health insurers, including UnitedHealthcare, Aetna, and Blue Cross and Blue Shield of Georgia, offering data on the cost of procedures to their members.
The state’s Department of Community Health receives information on hospital charges but is not required to share it with the public, Bailey said.
A hospital’s charges are not as important as the amount that’s paid or reimbursed, or the portion of that amount that’s paid by the patient.
New Hampshire has a public website where consumers can enter their health insurance, ZIP code, deductible and co-insurance, and get an estimate for prices in their area for a procedure or service, Bailey said.
On the nation’s overall grades, she said, “There’s a lot of work to be done. Not all of this has to be legislated.”