Healthcare Cost Transparency Differs Vastly by State

Although a majority of Americans are consistently surprised by their medical bills, the experiences differ greatly by state, according to a report from TransUnion Healthcare.

The survey is part of a series from TransUnion examining patient billing experiences as the healthcare system is transformed by the Affordable Care Act (ACA). According to respondents, just 25% of patients are offered pre-treatment cost estimates from providers, although there is demand for such information. More than 80% said receiving these estimates would be either “helpful” or “extremely helpful” in managing medical costs.

There are 5 states—Colorado, Maine, Massachusetts, Vermont, and Virginia—that have passed legislation to improve and encourage healthcare cost transparency. However, patients in these states are no more likely than those in others to have asked for or received front-end cost estimates, according to the survey results.

In fact, patients in these 5 states are less likely to ask for pre-treatment cost estimates (32% compared to the national average of 37%). None of the 5 states were one of the states where patients report it is easy to find cost information before treatment.

Concerns about costs are increasing more in smaller states. More than 60% of consumers in Colorado, Idaho, Nevada, New Mexico, Utah, and other western and mountain states reported an increased concern over healthcare costs. Meanwhile, less than 50% of consumers in large states, such as California, Florida, New York, and Texas, reported an increased concern over health costs since the implementation of the ACA.

Roughly a third of respondents in states with populations in the top third of US states reported it was easy to find pre-treatment cost estimates. In California 48% and in New York 40% of respondents said it was easy to find cost information before treatment. In less populous states like Idaho, Maine, New Mexico, and Vermont, less than 20% of consumers said it was easy to find this information.

The survey included responses from 7,407 people and was held between May 1 and June 1, 2014.