NH insurance officials say greater transparency would improve state’s health care market

State insurance regulators are studying ways to make New Hampshire’s health care market more transparent and control rising medical costs.

New Hampshire is already one of the few states with a comprehensive online tool that allows patients to compare what different providers charge for common medical procedures. The rollout of that website, NH HealthCost, in 2007 led to lower prices over time, according to a 2018 study of medical imaging services.

Public insurance officials say they would like to build on that success. The New Hampshire Insurance Department hosted three experts for a panel on price transparency at its annual hearing on health care premiums on Friday.

Insurance Commissioner DJ Bettencourt called price transparency a long-term project of the ministry. He said the ideas discussed Friday could inform policy discussions with the governor and lawmakers.

The main takeaway, I think, is that price transparency is a fundamental issue, he said after the panel at UNH Franklin Pierce Law School in Concord. The key is how best to approach it?

This comes as the healthcare industry in New Hampshire and the rest of the country becomes increasingly consolidated. Experts who spoke Friday said these mergers tend to lead to higher prices.

Hospitals that have market dominance are those that are able to command higher prices, said Chris Whaley, an associate professor at Brown University’s school of public health and a health economist at the group. research nonprofit Rand Corporation.

In contrast, he said there is only minimal correlation between the prices a hospital charges and the quality of its services.

Whaley presented data on the cost of different health systems, using what Medicare pays as a benchmark. He said these prices can vary widely.

In New Hampshire, for example, North Country Healthcare billed commercially insured patients about 1.5 times what Medicare pays, according to 2018 to 2020 claims data analyzed by Rand Corporation researchers. Meanwhile, prices at HCA Healthcare and LRGHealthcare (which has since become part of the Concord Hospital system) were about three times higher than Medicare rates.

Even among hospitals in the state of New Hampshire, prices vary by about two times, Whaley said.

Dr. Zach Brown, a health economist at the University of Michigan who authored the study on the NH HealthCost website, said transparency can reduce prices by allowing patients to shop around and giving employers more information. information when they choose their networks. It can also lead to increased scrutiny from journalists and regulators, which can put pressure on health care providers to lower prices.

One study found that nationally, 10 percent of individuals pay less than $700 for an MRI, he said. However, 10% of people pay more than $2,000 for the exact same MRI.

But for transparency to be effective, Brown may need to combine it with other policies, such as interventions to prevent health care monopolies.

If individuals can’t shop, if they don’t have a choice, then we don’t expect price transparency to do anything, he said.

Maureen Hensley-Quinn of the National Academy for State Health Policy, a nonpartisan health policy organization, said states are beginning to ban some anticompetitive contracting practices.

We cannot undo certain relationships, mergers and affiliations that have taken place, she said. However, you can try to mitigate some of the anti-competitive behavior that occurs once this happens.

Bettencourt said the presentation had many good ideas when it came to analyzing the contracting process between insurers and health care providers.

We want to ensure that the consumer benefits from the free market system, which means there must be healthy competition, he said.