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

Last modified: 8/21/2013 9:32:26 AM
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.)


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