Health Price Transparency Is Here

This is a preview of our Texas 2036 newsletter. To receive this weekly highlight of our work and important ways to stay engaged, sign up here.

How transparent are Texas hospitals with their health care pricing? 🏥

Room for Improvement: Health care prices can vary widely in Texas – even for the same service at the same hospital.

  • Without transparent prices, it’s hard for employers to design high-value benefit plans and to let their employees know what they’re going to end up paying when they get care.

Rules & Regulations: To allow for more informed decisions about health care spending, federal law required hospitals to provide clear, accessible pricing information about their services beginning Jan. 1, 2021.

  • Texas passed a similar law that went into effect in September 2021.

Facts & Figures: Working with data science firm January Advisors, we attempted to locate and download data for 644 hospitals in Texas. Here’s what we found as of April 2022:

  • 31% of hospitals were mostly compliant with the law* 
  • Only 65% of hospitals had made pricing data available in a way that we were able to access it
  • Many 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 the availability and formatting of hospital codes and insurer-specific information
💊 Health Price Transparency Tool: The disclosure of health care pricing data has the potential to significantly improve our understanding of health care markets.
  • Our new online tool examines the differences in prices for the same health care services to help show price discrepancies.
Texas 2036 To Do: To help lawmakers and all Texans, especially those communities disproportionately affected by high health care prices, get better care at a better price, we created a set of recommendations that will make 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 (read full list).
What’s Next: Beginning in 2023, insurers and employers will be required to provide their enrollees with consumer-friendly comparison shopping tools that show consumers their out-of-pocket costs for specific providers.

 

*What Does “Mostly Compliant” Mean?
Mostly compliant is the highest designation we classified any entity in our Health Price Transparency data. Because we do not have legal authority to request and verify certain additional data from the organizations we reviewed, we are unable to affirm whether any entity is “fully” compliant. Being graded “mostly compliant” does not indicate any identified deficiencies or a known lack of compliance on the entity’s part.
Health Care Costs 💰

Have you or someone in your household skipped or postponed medical care because of the cost in the last two years?

Take our short survey and let us know!

In the News 🗞️

Check out today’s editorial in The Dallas Morning News about our health price transparency tool.

Read it.

Texas 2036 Testimony 🎥: Health Care Reform

Press Play: Senior Policy Advisor Charles Miller testified before the Select Committee on Health Care Reform on Aug. 4 about why the state should continue to expand health care transparency, its need to empower employers to join the fight, and more.

Watch it.

Join the conversation:

Last week we asked how concerned you are about crime in your community? The current top result is “somewhat concerned.” Weigh in.

keyboard_arrow_up