Report says state could do more to make health care costs transparent
Vermont is not meeting a legal obligation to use its health care claims database to provide the public with consumer information, according to a new report from the State Auditor’s Office.
The report also found that Vermonters are taking on a growing amount of liability for their health care costs.
The number of high-deductible health plans has grown from 21 percent of the commercial market to 34 percent in three years from 2009 to 2012.
Plans sold on the state’s health care exchange, which opened last year, can leave families with as much as $12,700 in out-of-pocket costs on top of premiums, according to the report.
Making price and quality information accessible could help patients make value-based choices for non-emergency medical care.
The Vermont Health Care Uniform Reporting and Evaluation System (VHCURES) is an all-payer claims database with information on more than 100 million claims paid by commercial insurers, Medicaid and Medicare going back to 2007.
The auditor’s report describes it as, "a digital catalogue of all fees for medical services and products that insurers paid over the last seven years in Vermont."
State law requires it be used to assess the health care system capacity, inform policy, evaluate programs, compare treatment costs and approaches, improve the quality of health care and inform consumers.
The auditor’s report found Vermont has made progress on all but the charge to inform consumers using the claims data.
"It’s regrettable, but the fact is it’s not too late; they can do it now," State Auditor Doug Hoffer said. "And that appears to be their intention."
Hoffer said that consumer information on the price and quality of health care services will still be important, even if the state makes the transition to a single-payer program.
"Providers charge different amounts for different procedures all over the state regardless of whether there’s going to be two payers, one or five," he said.
Green Mountain Care Board Chair Al Gobeille said creating consumer tools using VHCURES data is something the board intends to do, but it’s going to take years not months.
"It’s a priority, but it’s not the priority," Gobeille said, noting that the board has limited resources and is managing several other health care reform initiatives.
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