Stethoscope and dollar sign Theneed for transparent health care pricing is even more pressingunder the COVID-19 pandemic because many consumers are facing jobloss and losing their health insurance. terstock)

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Advocates for accessible health care price information havegiven 34 of the 50 states a grade of F on their efforts to helpconsumers obtain cost data to help them shop around for medical care.

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The 16 states receiving passing grades in the Report Card on State Price Transparency Lawsrepresent a marked improvement from the last survey, in 2017, whenonly seven of the states got passing grades.

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Related: Even doctors aren't very good at shopping forhealth care

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The report, complied by Catalyst for Payment Reform, inconjunction with The Source on Healthcare Price and Competition atthe University of California Hastings College of Law, seeks topromote transparency in health care price information in order tofacilitate price shopping as well as expose extreme pricevariations, call attention to overpricing and promote competitionand lower prices.

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Maine and New Hampshire were the only states to receive gradesof A in the report. Colorado, Connecticut, Maryland andMassachusetts were each awarded a B, while Florida, Minnesota, NewMexico, Oregon and Virginia each received a C. Arkansas,California, Utah, Vermont and Washington each was awarded a D inthe report, and the remaining states each received an F.

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But the advances in access to information come amid dramaticgrowth in health expenses for U.S. households, withrising costs serving to reduce access to care for both the insuredand uninsured, the report says.

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"We want to ensure all Americans have access to priceinformation–we would like to see all the states move quickly onthat. However, having studied this for a number of years, the factthat we are seeing progress is encouraging," Suzanne Delbanco,executive director of Catalyst for Payment Reform, said in aninterview.

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The need for transparent health care pricing is even morepressing under the COVID-19 pandemic because many consumers arefacing job loss and losing their health insurance, while otherswill be facing rising health care premiums and copayments in themonths ahead, said Delbanco.

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"The costs of the COVID-19 pandemic and a severely troubledeconomy reemphasize the importance of transparency," Delbanco said."Access to price information in the private sector is largely inthe hands of health plans and providers, so it can be up to thestates to ensure that citizens have access to meaningful priceinformation."

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States that scored the highest for health care pricetransparency in the report were those that have passed legislationcreating a state-run database of pricing for common medicalprocedures at various hospitals and health care providers, or thosewhere the information is gathered by a private entity pursuant tostate law, Delbanco said. Catalyst favors the creation of aso-called all-payer claims database (APCD), pooling aboutexpenditures by Medicare, Medicaid and private insurance companies,for a complete view of what providers are charging.

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APCDs typically collect data from multiple payers, includingcommercial health plans, state employee health benefit programs,Medicaid and Medicare, and sometimes self-insured employer plans,the report said. APCDs are considered superior data sources becausethey include the amounts actually paid, not the amount charged,which often differ significantly. But Delbanco admits thatcollecting such data can be challenging, even in states with alegislative mandate, because providers have to agree to provide itin a certain format.

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In some places, legislation to create state health care pricingdatabases has been opposed by hospitals, Delbanco said. Prices arenot regulated and widespread consolidations of health careproviders has allowed them to have a large amount of market power,she said.

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"Community health systems have tremendous clout. They are largeemployers and are looked on fondly in many communities. It becomesvery challenging to regulate them in a meaningful way, so they seemto raise prices above what we consider competitive levels,"Delbanco said.

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A robust set of price data will include information on a widerange of inpatient and outpatient procedures and services, insteadof one or the other, or only a limited list of procedures andservices. And a robust set of price data will include informationon physicians and hospitals, instead of just one or the other, thereport said. It is more meaningful to see the entire price for ahealth care event or episode, rather than to see only a hospital orfacility price, or only a physician price, for a specificservice.

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Charles Toutant

Charles Toutant is a litigation writer for the New Jersey Law Journal.