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Monday, April 15, 2013

Ind. Gov't. - "Medical fees are tough to discover; Consumer-driven health care often like driving blind"

Maureen Groppe of the Gannet Washington Bureau's story on medical costs is on the front page of today's Indianapolis Star. It begins:

WASHINGTON — Hoosiers have more incentive than residents of most states to pay attention to how much it costs to go to the doctor.

About 1 in 10 nonelderly Hoosiers with private health insurance have a “consumer-driven” plan that combines a high deductible with a savings account to help pay the remaining costs.

That’s the sixth-highest rate in the nation.

Although such plans are aimed at controlling costs by giving consumers “skin in the game,” it’s not easy to get the price information needed to make informed decisions.

Indiana, like most states, doesn’t require the level of price transparency needed, according to a recent report by the Catalyst for Payment Reform (a group formed by several large employers such as Boeing, AT&T and Wal-Mart) and by theHealth Care Incentives Improvement Institute, which promotes evidence-based medicine.

The report gave Indiana and 28 other states an “F” for transparency. Seven states got a “D.”

“You have consumer protection laws in almost every state on pricing of menus in restaurants and price tags on vehicles in car lots,” said Francois de Brantes, executive director of the Health Care Incentives Improvement Institute. “But some patients get bills that are far greater than the price of a car, let alone the price of a meal in a restaurant. And you get it after the fact.”

Cost transparency could become even more important in Indiana if the federal government agrees to Gov. Mike Pence’s request to use a consumer- directed plan that requires cost sharing for the approximately 400,000 Hoosiers who could be newly eligible for Medicaid under the 2010 healthcare overhaul.

Indiana law requires that hospitals report to the state what they charge for a patient’s stay. But that charge can be very different from the amount a patient’s insurance company has negotiated and doesn’t indicate the patient’s share.

It’s also unlikely Hoosiers can make much sense out of the annual consumer guide that the Indiana State Department of Health posts on its site. Called the “Hospital Discharge Data Files,” it’s a bunch of files that have to be downloaded into a spreadsheet and decoded to understand the meaning of columns headed “HOSPID” or “APRDRG” or “XC.”

ILB: See also this ILB entry from Feb. 22nd, and this one from Dec. 19, 2012.

Posted by Marcia Oddi on April 15, 2013 09:08 AM
Posted to Indiana Government