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My Turn: Transparency is key in controlling health care costs



For the Monitor
Wednesday, March 23, 2016
New Hampshire is considered a national leader in health cost transparency, and the New Hampshire Insurance Department has played a key role in providing information to consumers. Almost 10 years ago, we developed the website NHHealthCost.org, which allows employers and consumers to compare the cost of medical procedures performed by different providers in the state, based on the prices insurance companies have paid for these procedures in the past.

NH Health Cost has put a spotlight on how much more a patient may pay for the exact same health care service, depending on whom they are treated by, and it has prompted insurance companies to design new health plans that pass on savings to members who get care in reduced cost settings. This helps not only consumers but also employers seeking ways to hold down the cost of employee coverage. It also stimulates healthy competition among insurance companies, as well as providers, because the cost of care – one of the largest components of premiums – is no longer a secret hidden from patients.

The website is accurate because it uses actual, anonymous claims data from insurance companies – we have access to this data thanks to a state law requiring health insurers to make health care data “available as a resource for insurers, employers, providers, purchasers of health care and state agencies.” The database created by this law has been used in countless ways to help researchers and members of the public understand what is going on in the state and to make better choices. NHHealthCost.org is just one of them.

Now, uncertainty over a U.S. Supreme Court decision could threaten the state’s transparency efforts.

On March 1, the court ruled in Gobeille v. Liberty Mutual that Vermont can no longer require the collection of claims data from employer health plans regulated by the U.S. Department of Labor under ERISA – a 1974 law designed primarily to protect employee retirement funds – if the employer plans are “self-funded” (the employer, not an insurance company, bears the risk of paying claims). New Hampshire’s law, unlike Vermont’s, is part of the state’s insurance laws, which may mean a different legal standard applies here. But the decision is creating uncertainty among insurance companies about what claims data they must submit to the state.

On Thursday, New Hampshire state senators will have the opportunity to vote for legislation designed to clarify New Hampshire’s data submission requirements consistent with the court’s decision. State Sen. Nancy Stiles has crafted legislation that will give self-funded employers subject to ERISA – not insurance companies – the choice of whether the data, with no personally identifiable information, should be included in the database. Giving employers this option will help support the health cost transparency New Hampshire has worked so hard to achieve and pave the way for advancements in the future.

The NH Health Cost website and the transparency it creates serve the interests of consumers in general, and employers in particular. Employers can be empowered to impact the cost of insurance premiums, and patients can reduce their out-of-pocket exposure by using health care resources more efficiently. The competition fostered by transparency gives employers and consumers a New Hampshire based solution for rising health insurance premiums. New Hampshire lawmakers should support Sen. Stiles’s amendment so we can continue to be a leader in health care cost transparency and the use of market competitive forces to address rising health insurance costs.



(Roger Sevigny is commissioner of the New Hampshire Insurance Department.)



(Correction: An earlier version of this story incorrectly referred to the author as Robert Sevigny.)




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