Health Care Prices: Website Shows Variability Across TX

Texas 2036’s new online tool examines the differences in prices for the same health care services, the implications for patients and taxpayers, and significant information gaps

Texas 2036’s new online dashboard — which shows health care pricing data in an easy-to-visualize format — vividly demonstrates price discrepancies that help drive higher and higher government spending, insurance costs, out-of-pocket spending, and health-related inflation — but also how few hospitals are providing pricing data in compliance with transparency laws.

Texas 2036 began researching this data as part of an effort to evaluate the true prices of various health care services around the state. However, inconsistent compliance with state and federal hospital price transparency laws limited what pricing data was available. So, as a first step, the organization focused on data provided by hospitals and their compliance with these laws.

The data available as of this spring suggests that only about 31 percent of Texas hospitals are mostly compliant with state and federal law,” said Charles Miller, senior policy advisor for health care at Texas 2036. “But even when data might be available, a lack of standards makes it really difficult to utilize. There’s a lot of room for improvement.”

To help facilitate those improvements, Texas 2036 is offering recommendations to make the data more accessible, including the adoption of a clear data standard that could encourage and improve reporting and provide researchers with better data for analysis.

“These data files offer the potential for a unique and vital reference point for Texas legislators and leaders as they consider options for reducing health care spending while maintaining high levels of care and access in every part of Texas,” said Texas 2036 Vice President of Data and Analytics Dr. Holly Heard.

By spotlighting and addressing market inefficiencies, we hope to help lawmakers and all Texans get better care at a better price — especially those communities disproportionately affected by high health care prices,” Heard said. “The disclosure of health care pricing data has the potential to significantly improve our understanding of health care markets.”

The new public dashboard, which can be found at pricetransparency.Texas2036.org, represents the most comprehensive, publicly available Texas health care pricing transparency tool to date. It analyzes pricing data for a range of health procedures and services, both statewide and within 11 Public Health Regions — providing Texans a snapshot of how prices for the same health care services vary among different hospitals, payers and geographic regions.

As part of an ongoing effort by federal agencies to empower employers and consumers to make more informed decisions about their health care spending, federal law required hospitals operating in the United States to provide clear, accessible pricing information about their services beginning January 1, 2021. Texas passed a similar law that went into effect in September of that year.

Working with data science firm January Advisors, Texas 2036 attempted to locate and download data for 644 hospitals in Texas. Analysts then reviewed and classified each of the data files. As of April 2022, key findings include:

• Only 65% of hospitals had made pricing data available in a way that researchers were able to access it. 
• 31% of hospitals were mostly compliant with the law, meaning that they listed standard charges, cash prices, minimum and maximum negotiated rates, and insurer-specific rates in their data. It is unclear whether the lists include all services offered at each hospital.
• Most large hospital systems in Texas are missing key pieces of data, such as insurer-specific rates.
• Comparisons between hospitals are often difficult or impossible due to issues with the availability and formatting of hospital codes and insurer-specific information.

Most insurers and employers were required to disclose their own transparency files as of July 1, 2022, and beginning in 2024 will be required to provide their enrollees with consumer-friendly comparison shopping tools that show consumers their out-of-pocket costs for specific providers.

To learn more about health care pricing transparency in Texas and access the data, visit: texas2036.org/health-price-transparency.