Bills would make Idaho hospitals post data on prices, outcomes

Some lawmakers want information readily available to the public.

adutton@idahostatesman.comFebruary 13, 2014 

Idaho is one of three states in the U.S. that lacks a website where patients can find out how much a knee surgery costs at a nearby hospital, how many of those surgeries a hospital does per year, or how well the hospital’s outcomes compare with other facilities.

“Idaho can’t be benchmarked,” said Denise Love, executive director for the National Association of Health Data Organizations. “Without a data system, you don’t really know a lot of what’s going on.”

Two bills before the House Health and Welfare Committee aim to change that.

Rep. Brandon Hixon, R-Caldwell, introduced a bill on Tuesday to build a website and a mobile application where patients could see prices for the 50 most common procedures at Idaho hospitals and surgical centers. The bill also would require health care facilities to give out more pricing information, such as estimates of charges and itemized bills when patients go home.

“The relationship between buyer and seller in the marketplace (for health care) is so tipped to the seller it’s not even funny,” Hixon told the Statesman.

Hixon told the committee that he estimates it would cost $1.7 million to set up the system, which would be done by an outside firm chosen by the state.

Members of the committee were skeptical. They questioned whether his cost estimate was realistic — Hixon said it was a quote from a firm — and how much it would cost hospitals and surgery centers to gather and provide the data.

Committee members also wondered how the website would promote competition in a community that has just one hospital with 25 beds.

“If a consumer can jump on the website” to see prices at a more distant hospital, “I’m quite sure they would make that drive to save $3,000 out of their pocket,” Hixon replied.

Hixon said he has met with stakeholders, and some of them aren’t on board with his proposal.

COST QUESTIONS

The Idaho Hospital Association thinks Hixon’s bill would fall short of providing transparency in a manner consumers could use to make health care decisions, said Toni Lawson, the association’s vice president of governmental relations.

“It can be challenging to navigate the system, but I don’t think a mobile app on your phone that gives you generic averages is going to make it one bit easier,” Lawson said.

“About seven or eight years ago, it was all the rage” for states to create websites with hospital data, Lawson said. The Idaho Hospital Association considered building such a database or website, “and the cost just wasn’t feasible.”

According to Love, the Utah system had an annual budget of $200,000 when it was getting started years ago. “Now it’s much more than that, because they collect more” information, she said. “Since Idaho is coming in late, we have states that have developed other technology solutions. ... You could really do it on the cheap.”

Because of the variety in insurance plans, such as different co-payments, a website that discloses average charges for certain procedures would not give an accurate picture of what a knee surgery actually costs the patient, Lawson said.

“Right now, it’s really much easier to pick up the phone and call your insurance company,” she said.

Some Idaho hospital data is already available online. The U.S. Department of Health and Human Services recently made available some information on pricing and performance. Websites such as www.medicare.gov/hospitalcompare offer a window into emergency room wait times, safety, patient satisfaction and other data for hospitals in Idaho. The Centers for Medicare and Medicaid Services last year revealed for the first time what hospitals nationwide charged for 100 common procedures, the number of those procedures the hospitals performed, and the actual dollar amount Medicare paid to the hospitals for each procedure.

RUSCHE’S PLAN

The hospital association favors a bill that Rep. John Rusche, D-Lewiston, introduced earlier this month.

That bill would require the Idaho Department of Health and Welfare to “investigate the creation of” a database of claims from all insurers, including Medicaid, and a separate hospital discharge database of hospital performance and other quality- and safety-related information. It also would establish an advisory committee to create a plan for those databases.

The planning process could be paid for by grants, but it likely would cost an unstated amount of money to keep the database up and running, according to the bill’s fiscal note.

“I’m not sure I know what the issues are around collection and submission” of hospital data, Rusche told the Idaho Statesman. “You don’t want to do something that imperils someone’s business practice, but at the same time, you need the data to aggregate.”

The bill does not specify how or whether the database would be accessible to consumers.

Audrey Dutton: 377-6448, Twitter: @IDS_Audrey

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