Medical Procedure Costs Available Online in Only Six States, Public Citizen Finds

The prominent consumer advocacy group Public Citizen indicates that individuals in most states are hard-pressed to find reliable information about the cost of medical procedures, keeping consumers in the dark when shopping for heath care services. 

In a report (PDF) released last week, Public Citizen outlined the findings of an investigation that revealed only six states provide publicly available websites on the cost of medical procedures, and even that information is often incomplete, inadequate or hard to access.

The group tested state consumer websites to see how hard it is for individuals to learn basic health care cost information. They looked for information on common procedures including colonoscopy, CT scans, hernia repair, knee replacement surgery and MRI scans.

“Shopping for health care prices in the United States is like trying to find a light switch in the dark,” Vijay Das, Public Citizen’s health care policy advocate and lead researcher for the study, said in an August 3 press release. “If you know where you should be looking – and it’s actually there for you to find – you might have a chance, but otherwise you’ll blindly search in vain.”

Researchers found that 19 states have legislation calling for the creation of all-payer claims databases (APCD), however, only six have found a way to make those databases available to compare health care prices, including California, Colorado, Maine, New Hampshire, Virginia, and West Virginia.

The states that have passed legislation to create the databases include Arkansas, Colorado, Connecticut, Kansas, Florida, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New York, Oregon, Rhode Island, Tennessee, Utah, Vermont, Virginia, Washington and West Virginia. However, after about $90 million in federal grants, most who have created the databases have not made them public, some are still in the process of creating the databases, and those that have made them public often have outdated and incomplete information, the analysis found.

Of all the states, the analysis found that New Hampshire’s website was the most useful, with cost estimates for all five procedures searched for by Public Citizen, and with data from 2014 and 2015. The site had the costs of about 75 medical procedures performed at about 45 facilities statewide. The researchers called it an “ideal template” for other states to follow.

The group also praised Maine and California’s websites, but noted that California’s data comes from 2010 to 2013, and Maine does not include costs covered by medicaid and other public payers or costs for the uninsured.

Public Citizen said that the information is crucial in a time where out-of-pocket health care costs are skyrocketing along with insurance deductibles.

“States should allocate more resources and build user-friendly websites that contain complete information,” Das said. “This is basic information, and it shouldn’t be so difficult to find.”