When we released our inaugural Report Card on State Price Transparency Laws in 2013, it was the first time policy makers, consumer advocates, and other health care leaders had a comprehensive resource showing how readily consumers could find health care prices in every state across the country. With so many states earning only a failing grade, it was clear a lot more action had to be taken by states to ensure consumers have reliable information on which to make important health care decisions. We were pleased, therefore, to see the 2013 Report Card start a dialogue and in some cases, prompt lawmakers to introduce legislation in 2013, even if some bills were not voted into law. With consumers taking on a rising share of their health care costs, access to meaningful price information is more important than ever.
In this year's Report Card, we decided to raise the bar, no longer grading state laws on a curve, as we did in 2013. We also decided to take a deeper look at whether these laws were achieving the ultimate goal—ensuring consumers have access to meaningful information about the price of their health care. For this reason, we expanded the scope of our inquiry to examine not only state laws on the books, but also states' price transparency regulations, price transparency websites, and all-payer claims databases, the ideal source of data for these websites.
Some states have robust price transparency laws and regulations, requiring them to create a publicly available website with price information based on real paid claims information; but in reality, the public can't readily access that information because the website is poorly designed, or poorly functioning. Given that so many state-mandated websites are inadequate, once we included websites into our review and grading, no state received an "A" in this year's Report Card. Unfortunately, New Hampshire—a state that received an A in last year's Report Card—dropped to an F this year, because its website is inoperative and may remain so for an extended period.
Several states have "voluntary price transparency websites," hosted by hospital associations, foundations, or nonprofits. While these sites can be a valuable resource to consumers, if they are not legislated they can be short-lived, dependent on the good will and resources of the organization that hosts them. For this reason, we did not factor in these websites when awarding the 2014 state grades; however, we did provide a review of them in Appendix I for comparison purposes.
This Report Card on State Price Transparency Laws is a joint effort between Catalyst for Payment Reform and Health Care Incentives Improvement Institute to examine consumers' access to price information in all 50 states, using well-defined grading criteria applied to laws, regulations, and state-mandated websites. The Methodology section of this report contains detail about these criteria.
As always, we welcome your thoughts and feedback. In the event that our research team overlooked relevant information, we strongly welcome your suggested edits and additions. We hope the Report Card will inform advocates, lawmakers, and policy experts about today's best practices or what constitutes a top grade and, over time, generate improvements in public policies and consumer websites across the nation. American consumers deserve easy access to robust information about the cost and quality of their health care and today they're not getting it.
Francois de Brantes, MS, MBA
Health Care Incentives Improvement Institute
Suzanne Delbanco, Ph.D.
Catalyst for Payment Reform