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Bill in N.H. House aims to publicize costs of health care procedures

New Hampshire was one of two states in the country to receive an “A” rating on an independent scorecard grading states’ transparency in health care pricing this spring. That was largely due to a state-run website that compiles average medical care prices and compares them by insurance plan and by procedure.

Lawmakers are debating this summer whether and how to improve health pricing transparency, possibly by shutting down altogether.

Salem Rep. Marilinda Garcia submitted a bill during the last session that would require all health care providers – hospitals, ambulatory surgical centers, doctors offices – to provide uninsured customers with a price list for the provider’s 25 most commonly performed procedures.

She had received pleas from friends, family and constituents struggling to find information about the potential cost of procedures, she said.

“There are some health care facilities that are very upfront and transparent. There are some resources online that can help. But there’s nothing comprehensive, and, obviously, the people that came to me had been really struggling, and they are intelligent, well-intentioned people. (The state website) is not the be all and end all,” she said. was authorized by a 2003 state law allowing the New Hampshire Insurance Department to collect and analyze billing data from hospitals and insurers in New Hampshire after removing all patient identification. It allowed the state to study what hospitals were charging and establish a website where consumers could see what their costs would likely be for a procedure at any hospital. However, the website’s cost predictions are based on past billing information, calculations that can be done only after the department collects enough bills in each category. Not every procedure has yielded the needed critical amount of data, so not every possible procedure is listed.

Under a federal grant program to encourage states to build websites like, the state could be eligible to receive as much as $1.5 million to use over the next 18 to 24 months, said Tyler Brannen, a health policy analyst at the insurance department. Since the department already built the site, it could use the grant funds to add more procedures or possibly build a way for providers to update their information more frequently; the site is now updated every quarter.

At a House subcommittee meeting yesterday, multiple members of the public and of the Health, Human Services and Elderly Affairs committee said Garcia’s legislation is unnecessary. Some claimed already fills this role, while others said the state should leave the issue alone entirely.

Donald LeBrun, a Nashua representative, said efforts should be directed instead to promoting and updating the insurance department’s site.

Nick Vailas, who was commissioner of the state Department of Health and Human Services for several months in 2003 and is CEO of the Bedford Ambulatory Surgical Center, said the private market would fill the need if the raw information were publicly available.

“This (bill) is more government obstruction. . . . I was involved in that site when I was commissioner, and it is not user-friendly,” he said. “If people can just access the data, there are companies and entrepreneurs that will make it available such that a regular consumer can use it.”

The subcommittee will meet again Sept. 10 to develop a new draft of the bill to forward to the full committee.

Garcia was optimistic after the hearing despite the general sense that her bill will be largely rewritten.

“I sponsored the initial legislation to bring about transparency, equity and consumer choice. The bill was a way, a vehicle to get started in some direction,” Garcia said. “That intent is not lost by going in a completely different direction.”

(Sarah Palermo can be reached at 369-3322 or or on Twitter @SPalermoNews.)

Legacy Comments5

Mr. Vailas should know that the claims data files are available (for free) from the NH Comprehensive Health Information System for use by researchers, hospitals, health plans, and others. More than 100 requests for these data have been fulfilled since 2005, the majority of which have been to the "private market" (insurers, providers, data vendors) to which he refers.

sure any office will provide you with their price list for a is called a consultation after a diagnosis which will list at; starting at $700 to $2500...depending on the test needed to diagnose your ailment. Now lets see maybe we should have them pass a law listing the costs for attorney's fees, then start by making them abide by the current obamacare law and make them hit the deadlines that they created, making all abide instead of giving waivers and last but not least stop suspending provisions of a law that they have no constitutional power in doing! UNBELIEVABLE!

Although the intent of the website is a good one, it is riddled with wrong information due to a number of things: the way the information is gathered, the assumption of coding that doesn't specify variations in procedure, and the incorporation or lack of incorporation of radiologist reading fees, as an example. Most hospitals are very reluctant to be transparent with their fees, mostly due to cost-shifting of fees within a hospital setting. However, independent imaging centers such as Derry Imaging, have a cost-calculator on its website that is accurate and specific to every modality of imaging. They are always just a fraction of the cost of hospital imaging, and more than happy to encourage comparison shoppers. Make sure you get the correct billing code for your prospective procedure and know for sure if it includes the radiologist report!

didnt democrats promise to focus like a laser on jobs?

Ya might better check on who submitted the bill. She is a conservative. In other words a Republican from Salem.

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