Children, Families, Health, & Human Services Interim Committee

Health Care Price Transparency Subcommittee Begins Work

Committee: Children, Families, Health, & Human Services Interim Committee
Author: Sue O'Connell
Posted on October 4, 2017

image of a an explanation of benefits for an insurance claim

A subcommittee of legislators and stakeholders has begun work on a study of transparency in health care pricing by setting out the purpose, topics, and goals of the study and hearing about factors influencing the cost of health care.

Subcommittee members used a consensus approach in establishing the purpose of the study. They agreed it will look at ways the state can ensure that health care consumers receive transparent information about price and options for comparable health care services.

Members also agreed the study should look at health care costs, reimbursements, and prices, consumer and purchaser needs and responsibilities, pricing information in Montana, initiatives in other states, quality of services, and the role of the state in price transparency. They also agreed that educating people about all of those topics needs to be considered.

The subcommittee goals include understanding provider costs and reimbursement sources, identifying factors that set prices, determining what consumers want and need to know, and identifying the role of the state. The members noted they may expand the goals as the study progresses.

Also during the meeting, the subcommittee heard from a panel of health care providers about health care costs. The panelists answered specific questions about the nonprofit or for-profit status and the profit margins of their respective organizations, the costs of providing services and the breakdown of their business expenses, cost trends over the past three to five years, and efforts they've made to reduce costs.

Panelists represented a large hospital, a critical access hospital, a physician-owned practice, and a dental practice. Speakers noted that personnel costs make up the biggest portion of their costs of doing business, with equipment and supplies also representing a relatively large portion of expenses.

Next Meeting

The subcommittee will meet next at 8:30 a.m. on November 16 in Room 137 of the Capitol. For more information about the meeting or the subcommittee's activities, visit the HJR 20 Study page of the Children, Families, Health, and Human Services Interim Committee or contact Sue O'Connell, committee staff.

Committee Website:
Committee Staff: or 406-444-3597