Hospital Pricing

Marilyn Bartlett, CPA, CMA, CFM, Senior Policy Fellow from the National Academy for State Health Policy (NASHP), joined our February meeting to discuss NASHP's national initiative to assist states in containing healthcare costs. NASHP and the RAND Corporation have produced materials to support state efforts around hospital costs and strategies for cost containment. Ms. Bartlett shared the RAND materials and her story of cost containment on behalf of the State of Montana employee health plan.

NASHP and Marilyn Bartlett's work led to the development of NASHP's Hospital Cost Tool, which helps health plan purchasers and regulators better assess health system costs.

RAND Corporation's recently released study, Nationwide Evaluation of Health Care Prices Paid by Private Health Plans (referred to as "the Rand Report") reveals that employers and private insurers across 49 states and Washington, DC pay, on average, 247% of what Medicare reimburses for those same hospital services, including both facility and professional fees for inpatient and outpatient care. Researchers analyzed hospital claims data representing $33.8 billion from 2016-2018 for 3,112 hospitals located in every state (including New Hampshire) to better highlight hospital prices, which are typically opaque.

The presentation can be found here.

New Hampshire HealthCost
Developed by the New Hampshire Health Information Center, NH Institute for Health Policy and Practice and websolutions for the NH Department of Insurance, in conjunction with the Department of Insurance Advisory Council, this Web site is intended to give consumers a better understanding of the cost of healthcare to insurers and patients. It is also designed to help consumers make informed decisions about what type of insurance product may best meet their needs.

A service of the U.S. National Library of Medicine and National Institutes of Health, this online resource provides: consumer-friendly health information on health and wellness topics; directories of hospitals, physicians and dentists; a medical encyclopedia; and more.

The Leapfrog Group
Focuses on the quality of certain aspects of care relevant to urban area hospitals and provides important information and solutions for consumers and healthcare providers.

Hospital Compare
Hosted by the U.S. Department of Health and Human Services, this site provides information on how well hospitals in your area care for adult patients with certain medical conditions. It was created through the efforts of the Centers for Medicare and Medicaid Services (CMS) and organizations representing hospitals, doctors, employers, accrediting organizations, other federal agencies and the public.

HealthGrades provides healthcare ratings, information and advisory services. The website allows consumers and employers to research facilities for quality ratings on many common healthcare procedures.

Developed by the U.S. Department of Health and Human Services, this award-winning website for consumers links to information from more than 1,700 health-related organizations.

Foundation for Healthy Communities
This nonprofit corporation exists to improve health and health care, and includes New Hampshire hospitals, health plans, clinicians, home care agencies and public policy leaders. Its website features a downloadable N.H. Prescription Guide, N.H. Prevention Guidelines and more.

Centers for Disease Control and Prevention
Click on "Health & Safety Topics" selections for information on Diseases & Conditions, Health Promotion, Vaccines & Immunizations and more.

Health Insurance Purchasing Guide for Employers
Choosing a health insurance plan for you and your employees is one of the most important things you can do for your business. There is a broad array of products offered in New Hampshire and the choices can often be confusing. This is a list of ten questions that you are encouraged to ask your health insurance broker or purchasing director. The questions are primarily focused on two areas: benefits and costs of the plan offerings.

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