Dive Brief:
- The Maryland Health Care Commission's Wear the Cost initiative to help consumers compare prices for common non-emergency procedures at hospitals now includes price and quality data based on commercial insurer data from 2015 and 2016.
- The website allows Maryland consumers to create a custom report comparing the cost and quality for episodes of care across hospitals, designed to be used in conversations between patients and providers.
- Maryland is one of a handful of states experimenting with an all-payer model. A study published in the spring found the model did not reduce hospital use or spending among rural acute hospitals between 2010 and 2013. A CMS evaluation published a week prior, however, found the contrary.
Dive Insight:
Maryland has high hopes that its all-payer model will cut costs and reduce hospital use, and this program is aimed to push consumers to help drive those costs down.
The state's pricing initiatives are worth watching. According to a recent JAMA Network report, hospitals are generally not getting better at providing price estimates for procedures, despite an industry-wide push to provide that information to patients. The study's authors found "sobering evidence" that the issue of price transparency is actually getting worse. The percentage of hospitals that weren't able to give any price information increased from 14% to 44% between 2012 and 2016.
MHCC is hoping to reverse that trend with its Wear the Cost pricing tool. Price transparency, seen as a way to boost healthcare consumerism and cut costs, is part and parcel with policymakers' push for patients to shop around for the services they need. While MHCC's initiative does shine a light on costs of common procedures, it is not designed to be a price shopping tool.
Study after study has shown Americans do not price shop for healthcare. Despite the rise of consumerism in healthcare, even the tidal wave of high-deductible health plans isn't driving people to become more keen healthcare consumers.
CMS is pushing for improvements to pricing transparency that includes requiring hospitals to post prices online. The proposed rule would require hospitals to publish a list of their standard charges online and update that information at least once per year. The agency is asking what enforcement mechanisms would be appropriate to encourage price transparency from hospitals, such as imposing civil money penalties for those that don’t comply.