Montana State Legislature
HJR 20
HJR 20: Health Care Price Transparency
The 2017 Legislature approved House Joint Resolution 20 requesting a study of transparency in health care pricing. The study was the top-ranked study in a post-session poll asking legislators to prioritize the 20 study resolutions approved in 2017.
HJR 20 asked that the committee look into the following items:
- factors influencing the cost of health care services, including differences attributable to different delivery system models;
- efforts undertaken in other states and by organizations within Montana to make health care cost information more widely available to consumers;
- ways to improve consumer understanding of the different factors affecting the costs that are charged and the costs they must pay;
- ways to encourage consumers to make informed health care decisions;
- existing price transparency tools and health quality measures;
- ways to ensure that price transparency efforts give consumers information about both costs and quality of services; and
- the role of the state in improving health care price transparency.
The committee decided at its June 2017 meeting to have a subcommittee made up of legislators and members of the public work on this study during the interim. Rep. Kathy Kelker was appointed presiding officer of the subcommittee, which met for the first time on Sept. 12, 2017. At that meeting, members focused on trends and factors in health care costs. At a January 2018 meeting, members reviewed pricing and reimbursement for health care services and also learned about model cost reduction plans. In February, the subcommittee discussed items that consumer want to know about health care prices, learned about the complexity of the medical billing process, and reviewed existing transparency tools operated by health care providers and insurers.
The subcommittee held its final meeting on March 21 and recommended that the Children and Families Committee:
- offer strong support for the maturing of the Montana Health Insurance Exchange;
- seek advice from the Office of Public Instruction concerning health literacy for high school students;
- not pursue committee legislation on transparency tools or additional state guidelines for price transparency;
- allow individual legislators to develop legislation to clarify consumer responsibility for out-of-network bills and balance bills, perhaps by starting with the originally amended version of House Bill 123 from 2017; and
- pursue options for reducing prescription drug costs by hearing in June about the State Auditor's Office work on this topic and possibly following up on that information.
The full committee accepted all recommendations except the one related to prescription drug costs. For a copy of the letter sent to OPI, click here. The committee approved a final report on the study at its June 2018 meeting.
Study Reports
- Final Report on the HJR 20 Study: Health Care Price Transparency
- Subcommittee Recommendations to the CFHHS Interim Committee
- Considerations Related to Colorado SB 65, Sue O'Connell, March 2018
- Considerations Related to Colorado HB 1330, Sue O'Connell, March 2018
- Colorado Transparency Bill Rating, Rep. Kathy Kelker, March 2018
- Considerations Related to NAIC Surprise Bill Provisions, Sue O'Connell, March 2018
- Report to the CFHHS Interim Committee: February Meeting, Rep. Kathy Kelker, March 2018
- Report to the CFHHS Interim Committee: January Meeting, Rep. Kathy Kelker, January 2018
- Components of High-Quality State Price Transparency Resources, Compiled by Rep. Kathy Kelker, February 2018
- Topic Terminology for Feb. 16, 2018, Compiled by Rep. Kathy Kelker and Sue O'Connell
- Topic Terminology for Jan. 17, 2018, Compiled by Rep. Kathy Kelker and Josh Poulette:
- Report to CFHHS Interim Committee: September Meeting, Rep. Kathy Kelker, October 2017
- Current Law and 2017 Legislation, Sue O'Connell, August 2017
- Topic Terminology for Sept. 12, 2017, Rep. Kathy Kelker and Josh Poulette, August 2017
Pre-Meeting Reading Materials
- Feb. 16, 2018
- The Medical Billing Process and Use of Coding, Carnegie Mellon University Open Learning Initiative
- Association Between Availability of a Price Transparency Tool and Outpatient Spending, Sunita Desai, et. al.
- Patients' Views on Price Shopping and Price Transparency, Hannah L. Semigran, et. al.
- Supporting Informed Consumer Health Care Decisions, Judith H. Hibbard and Ellen Peters
- Best Practices to Maximize Consumer Use, Judith Hibbard
- Colorado Senate Bill 65, 2017
- Are Price Transparency Tools Actually Working?, David Hines, ConsumerMedical, op-ed
- High Cost Claimants: Private vs. Public Sector Approaches, American Health Policy Institute
- Waste in the Health Care World: An AHPI/VBID Collaboration, American Health Policy Institute
- Why Health-Care Price Transparency Isn't Enough for Consumers, Wall Street Journal
- Doctors Aren't Grasping for Cost Transparency Tools, Richard Mark Kirkner, Managed Care Magazine Online
- Jan. 17, 2018
- Montana Code Annotated
- 50-4-512: Disclosures Required of Health Care Providers
- 50-4-512: Disclosures Required of Health Insurers
- How Much Should We Spend on Medical Care?, Health Policy Issues-An Economic Perspective: Sixth Edition, Paul Feldstein
- A Way Forward for Bipartisan Health Reform?, American Journal of Public Health Editorial, October 2017
- Singapore Healthcare, William A. Haseltine, The Fiscal Times, June 17, 2013
- Montana Health Care Innovation Plan, Governor's Council on Health Care Innovation, June 2016
- Montana Code Annotated
- Sept: 12, 2017: The Rise of Medical Expenditures, Health Policy Issues-An Economic Perspective: Sixth Edition, Paul Feldstein
Related Links and Study Materials
- NASHP Model Drug Importation Legislation
- Memo Regarding Montana Informed Patient Website, Montana Hospital Association, February 2018
- Health Literacy, Barbara Schneeman, RiverStone Health, February 2018
- 2017 Montana HIE Planning Project Report Abstract, Montana Medical Association/Montana Healthcare Foundation, February 2018
- Summary: Big Sky Care Connect
- Billings HIE Pilot Project Update, Carol Jones, Billings Clinic, February 2018
- Overview of Billing Process, Clayton Fosjord, February 2018
- Introduction to Reimbursement and Pricing, Steve Loveless, CEO, St. Vincent Healthcare, Billings, January 2018
- Billings Clinic PowerPoint Presentation, September 2017
- Population Health, Billings Clinic, September 2017
- Overview by Ortho Montana, September 2017
- Oral Health Care Costs and Transparency in Fees, Dr. Kurt Lindemann, September 2017