A new law in Massachusetts
mandates transparency in healthcare services pricing, allowing anyone in
the state with private health insurance to go to their insurer's
website and find out how much a given procedure-office visit or MRI-is
going to cost. That's actually pretty huge, as WBUR's Martha Bebinger
reports in conjunction with Kaiser Health News.
It's a seismic event. Ten years ago, I filed Freedom of Information Act
requests to get cost information in Massachusetts - nothing.
Occasionally over the years, I'd receive manila envelopes with no return
address, or secure .zip files with pricing spreadsheets from one
hospital or another.
Then two years ago, Massachusetts passed a law
that pushed health insurers and hospitals to start making this
once-vigorously guarded information more public. Now as of Oct. 1,
Massachusetts is the first state to require that insurers offer
real-time prices by provider in consumer-friendly formats.
"This
is a very big deal," said Undersecretary for Consumer Affairs and
Business Regulation Barbara Anthony. "Let the light shine in on health
care prices."
Amen. Healthcare pricing is notoriously varied and indiscriminate. A
procedure that costs several hundred dollars at one hospital can cost
in the thousands at a hospital in the next town, and essentially no
insurer pays the same for a given procedure as another insurer. It's
part of the multi-layered dysfunction in our system that has helped to
drive costs so high. This is a great start toward some transparency,
that can hopefully, eventually lead to some rationality in pricing.
That's with a bunch of caveats, though, that Bebinger details.
First, looking at the price of a test or procedure at one site won't
tell you necessarily what it should cost-this is where variance comes
in. Bebinger checked out bone density scans: $16 in Tufts Health plan;
$87 in Harvard-Pilgrim Health Care's system; $190 for Blue Cross Blue
Shield of Massachusetts. Some of the prices reflect all of the charges
included in the test-for example anesthesia included with some invasive
tests-but others aren't inclusive. The law doesn't have a definition of
"price" and what all that should include, so what you see on the
insurer's website might not be what you get. Additionally, Bebinger
found that prices tend to change, and change frequently. Within five
days, the price for the bone density scan she researched increased from
$120 to $190 at Blue Cross.
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