Health Care Price Transparency Subcommittee Wraps Up Work

Committee: Children, Families, Health, & Human Services Interim Committee
Author: Sue O'Connell
Posted on April 5, 2018

---

---

The subcommittee looking at transparency in health care pricing finished its work on March 21 by suggesting that state policymakers allow existing efforts in this area to evolve on their own. Members noted that the health care landscape is changing in ways that could make any efforts undertaken now obsolete within a few years.

The Children, Families, Health, and Human Services Interim Committee created a 15-member subcommittee that included four legislators and 11 representatives of health care providers, insurers, businesses, state agencies, and consumers to take an in-depth look at the topics outlined in House Joint Resolution 20. The resolution asked for a study of the factors influencing health care prices, ways to improve consumer understanding of those factors, and the role of the state in improving price transparency.

Over the course of four meetings, the subcommittee reviewed existing cost-disclosure laws in Montana, as well as legislation from other states. Members also looked at transparency tools used in other states and saw demonstrations of the transparency sites operated by the Montana Hospital Association and Blue Cross Blue Shield in Montana.

They also discussed the information that consumers need in order to make informed decisions; reviewed the complexities around medical billing and the problems caused by “surprise” bills for unexpected out-of-network services; looked at various models for providing health care services; and learned about a Billings pilot project and a statewide effort related to sharing patient health information among providers and insurers in an effort to coordinate care and reduce duplicative services.

At their final meeting, members recommended that the Children, Families, Health, and Human Services Interim Committee not pursue any legislation related to an all-payer transparency tool or additional state guidelines for price transparency. They also recommended that the full committee:

• offer strong support for the maturing of the Montana Health Insurance Exchange effort that is currently underway, saying it may result in better coordinated care and reduced costs;
• seek advice from the Office of Public Instruction about the best way to approach health literacy for high school students;
• allow individual legislators to pursue bills to clarify consumer responsibility for out-of-network bills and balance bills, perhaps using an amended version of House Bill 123 from the 2017 legislative session; and
• pursue options for reducing prescription drug costs. The subcommittee suggested that the committee hear a planned presentation on drug prices from the State Auditor’s Office in June and consider following up on the new information.

On March 23, the full committee accepted all of the subcommittee recommendations except the one related to prescription drug costs.