Mass. First State To Require Insurers To Post Provider Prices Online

October 10, 2014 in News

Massachusetts earlier this month became the first state to require insurers to post online up-to-date prices for health care procedures by provider, WBUR/Kaiser Health News reports.

Background

A 2012 state law requires insurers and providers to make prices public and available in a consumer-friendly format. The law took effect on Oct. 1, 2014. According to WBUR/KHN, it is unclear if all insurers met the deadline to post the information, but “all the major players did.”

Price Comparison Details

Massachusetts consumers can now compare prices via their insurers’ websites. In addition, the sites include online calculators to allow consumers to calculate, if applicable, how much they will spend toward their deductibles and their out-of-pocket maximums.

According to WBUR/KHN, there are several issues with the data. For example:

  • Listed prices vary by insurer and provider — because such rates are the result of individual negotiations — with the price of an upper back MRI ranging from $614 to $1,800;
  • Most prices are listed for outpatient care, and there are not many prices listed for inpatient care;
  • Not all insurers list prices for the same tests and procedures;
  • Patient satisfaction scores comprise most of the available quality data, with little information available on other quality measures;
  • Prices seem to change frequently; and
  • Some posted prices do not include all charges, such as facility fees.

Reaction

Bill Gerlach, director of member decision support at Blue Cross Blue Shield of Massachusetts, said, “As more and more members are faced with greater and greater cost share, this sort of information is really important.”

Barbara Anthony, state undersecretary for consumer affairs and business regulation, said she is hopeful that the price transparency will result in more competition among providers, which could result in lower prices (Bebinger, WBUR/Kaiser Health News, 10/9).

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