INDIANAPOLIS — Carma Parrish’s insurance once saved her $800 by recommending a different provider for her husband’s MRI, reducing out-of-pocket costs to $400 instead of $1,200. It’s just one example of how price transparency can save patients money.
“I didn’t have the job I have now,” Parrish, the CEO of NorthPark Community Credit Union, said. “I was living paycheck-to-paycheck.”
Parrish addressed to the Indiana House Public Health Committee about the negative financial impacts surprise medical bills can have on their constituents, testifying about the need for price transparency.
“Most of the people you (Indiana legislators) serve live paycheck-to-paycheck … they would love this. Three out of five members I see have medical collections on their credit report,” Parrish said. “They are paying three times more to buy a car because they have that collection (on their credit report).”
Parrish and several others discussed various aspects of a proposed bill from Rep. Donna Schaibley that would establish an all-payer claims database, which compiles costs of different hospitals and also requires providers to give cost estimates at the patient’s request.
“The goal of this legislation is to make sure the billing process is very clear,” Schaibley, R-Carmel, told the committee. “The rising cost of health care is impacting wages and health care debt is impacting the everyday life of people in our state. We need to take decisive action.”
Studies last year from the RAND organization reported Indiana’s high health care costs, especially at hospitals, relative to other states.
If passed, the Department of Insurance would solicit bids from a third party to create a database based on previous procedures stripped of identifying information.
Gloria Sachdev, the president and CEO of the Employers’ Forum of Indiana, said her organization commissioned the RAND studies at members’ request after seeing price differences for their businesses across state borders.
“We’re lucky; we have good hospitals providing a good quality of work and we don’t have a huge access problem that other states have … but we have a price problem,” Sachdev said. “This is a really great first step in price transparency.”
The organization describes itself as a health care coalition of employers, physicians, hospitals, health plans and public health officials. Sachdev said that large corporations could pass savings on health care expenses to employees.
“The schools are paying a ton of money for health care and if they weren’t paying so much for health care they would have more money for teacher raises,” Sachdev said.
Brian Tabor, the president of the Indiana Hospital Association, discussed some of the additional steps legislators would need to take to tackle the problem of pricing in Indiana.
“There’s a lot more that we need to know before we make broad, sweeping policy changes and I think the all-payer claims database will position us very well for the future,” Tabor said. “We need to talk about pharmaceutical prices; we need to talk about insurance profits. All of those things have to be part of the total health care costs equation if we’re really going to solve the problem.”
Tabor said employers themselves could find other models for saving money on health care costs by looking outward at other states and said consumers might be overwhelmed by the amount of data that would be included in the database.
“The all-payer claims database, we really support that,” Tabor said. “We do think that providers need to have some stake in the governance.”
Within 72 hours of a procedures, patients may ask for “good faith” estimates of charge and health care providers must advertise the availability of this service on public signs and provide internet services to access the database, according to the bill.
Many testified that the bill was a first step in decreasing costs by forcing providers to be competitive but said more work needed to be done.
The committee didn’t vote on the bill Wednesday but adjourned to consider amendments at a later date.
Another cornerstone of the Republican health care agenda for the 2020 session was to address youth tobacco use. Rep. Cindy Kirchhofer, R-Beech Grove, introduced the bill that would raise the minimum age of purchase from 18 to 21 and impose stiffer penalties for violators.
The bill passed out of committee with one no vote and heads to the full House, but Kirchhofer said that amendments should be considered for violations and enforcement.