Only six states make information about the cost of medical procedures available to patients online, and that information usually is uneven, outdated, difficult to navigate, or unavailable, a Public Citizen study shows. The six states are California, Colorado, Maine, New Hampshire, Virginia, and West Virginia.
Public Citizen examined state consumer websites to fine out just how easy – or difficult – it is for consumers to get basic information about health care costs.
Nearly 20 states have tried to track health care payments to help their consumers and researchers better understand the costs of basic medical procedures in their state, but the efforts aren’t helping patients, Public Citizen found. The conclusion: States have a long way to go to provide adequate information for consumers to help them avoid being ripped off.
“Shopping for health care prices in the United States is like trying to find a light switch in the dark,” said Vijay Das, health care policy advocate for Public Citizen, who conducted the analysis. “If you know where you should be looking – and it’s actually there for you to find – you might have a chance, but otherwise you’ll blindly search in vain.”
Out-of-pocket health care costs for patients are increasing rapidly in the U.S. Since 2010, insurance deductibles for workers have risen three times as fast as premiums and about seven times as fast as wages and inflation, according to the Henry J. Kaiser Family Foundation. For nearly two decades, states have attempted to address this problem by passing laws to allow policymakers, researchers, and consumers to better understand and access health care cost information.
Using nearly $90 million in federal grants, 19 states have created – or are in the process of creating – databases using reports from providers, insurers, or both. But most of these databases aren’t available to the public. Among the few that are, the information offered by most is outdated and incomplete.
The 19 states are Arkansas, Colorado, Connecticut, Kansas, Florida, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New York, Oregon, Rhode Island, Tennessee, Utah, Vermont, Virginia, Washington, and West Virginia.
Public Citizen looked for cost information about five common medical tests and procedures: a colonoscopy, a CAT scan of the head, hernia repair, knee replacement, and a MRI of the brain.
Public Citizen found that:
- Prices vary dramatically. They’re highest for people without insurance.
- Of the six states that give consumers a chance to compare medical prices, few provide adequate cost information for the most common procedures. For example, Colorado doesn’t make available price information for colonoscopies, CT scans of the head, hernia repair exams, or MRIs of the brain. A privately insured Colorado resident can access claims data only from 2012.
- Only one state – New Hampshire – provides cost estimates for all five of the medical procedures. The website permits users to search the costs of about 75 medical procedures at about 45 facilities, and data is from 2014 and 2015. New Hampshire’s website is a good example for other states.
- California provides cost and quality data in five broad areas: childbirth care, hip and knee replacement, back pain, colon cancer screenings, and diabetes treatment. Although it offers information for regions, it doesn’t offer it for individual providers. The data is from 2010 to 2013, but the website is easy to navigate.
- Maine includes relatively up-to-date costs submitted by 42 health insurance plans for more than 240 procedures from more than 150 facilities. It doesn’t include costs covered by public payers, including Medicaid, and doesn’t include bills to the uninsured. The website is easy to use to comparison shop.
- Virginia’s website allows a resident to survey average costs for 31 procedures based on reports received from nine health insurance carriers. But the website was last updated in 2013, and the data is from 2012. The website is difficult to use.
- West Virginia’s website provides estimates of what hospitals would charge patients and is difficult to navigate.
“States should allocate more resources and build user friendly websites that contain complete information,” Das said. “This is basic information, and it shouldn’t be so difficult to find.”