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AHA finally supports federal price transparency legislation; the states are taking the lead

September 25, 2006

This month, the American Hospital Association has made an about-face and is now supporting a bill in Congress that promotes price transparency.  The information made available under such a scheme would clearly be a boon to consumer directed health plans (see HealthBlawg posts on CDH), including plans making use of health savings accounts (see HealthBlawg posts on HSAs).  The realities of the marketplace have pushed the AHA in this direction.

Modern Healthcare reports: 

The move is remarkable considering how vehemently the AHA has fought previous disclosure proposals that have been bandied about on Capitol Hill.

Though political realities in Washington almost ensure the bill won’t see a vote anytime soon, it’s the first shot across the bow from the AHA in a battle over what kind of pricing information hospitals should provide.

And given the AHA’s role in the bill, it’s perhaps not surprising that the bill doesn’t draw a hard line. The bill, H.R. 6053, would require states to enact laws that require hospitals and insurers to make known how much they charge for certain inpatient and outpatient procedures. The bill also would give insured individuals a cost-estimate for certain procedures and calls for a study from the Agency for Healthcare Research and Quality to determine what kind of pricing information is most relevant to the consumer.

A couple dozen states already have some form of price transparency laws on the books.  The challenge will be to link price information with quality information (see recent HealthBlawg post on IOM report regarding P4P). 

As an example of one state’s journey along this road, consider the Massachusetts experience.  The state’s universal health care law calls for publicizing both cost and quality information (see Boston Globe article published today, and links to the law and related information on the Massachusetts legislature’s home page).  Some data is already available on the state’s Division of Health Care Finance and Policy website.  It’s a work in progress.

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Filed Under: Consumer-Directed Health, Health Law, Health Savings Accounts, HIT, Hospitals, Managed Care, Massachusetts, Pay for performance, Universal Health Care

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