Improving Price Information
How is TDI Working to Improve the Availability and Quality of the Price Information Presented on this Site?
TDI has received a grant to promote health care price transparency in Texas. One of the key initiatives under this grant is to improve the quality of the information presented in this Reimbursement Rate Guide. Experts at the School of Public Health at the University of Texas Health Science Center at Houston (UTSPH) are helping to identify issues with how TDI collects and presents health care price information.
Why Did I Get a Different Price?
Prices for health care services sometimes vary significantly from one health care provider to another. Some of this variation is due to the service environment. For example, getting treatment in a hospital tends to be more expensive than getting the same treatment in your doctor's office. Some of the variation in health care prices is based on the contracts between different health insurers and providers. For example, an insurer with a large number of enrollees in a region might be able to negotiate a higher "bulk discount" than an insurer with fewer enrollees in a region. Alternatively, a large hospital or clinic system might be able to negotiate higher prices with insurers than an independent hospital or physician.
This website reports the average billed, paid, and contracted or allowed amounts for certain services, based on data provided by health insurers and HMOs in Texas. UTSPH has identified several issues that affect the accuracy and relevance of up to 70% of the data. These issues are summarized in a presentation that TDI shared with stakeholders April 15, 2014. Until these issues are addressed, TDI has removed some of the data collected from the price look-up tool. For those interested in the technical details of TDI's data collection, you can view the data collection form and instructions and the data that feeds the Reimbursement Rate Guide.
What if I have Suggestions?
Great! Please tell us what you think. We are currently gathering information from all interested stakeholders on how we can collect accurate information on health care prices and present them in a way that makes sense to consumers.
Where Can I Get More Accurate Information on Health Care Prices?
When the 80th Texas Legislature instructed TDI to collect and report reimbursement rate data, they also required health plans to provide cost estimates to enrollees and health care providers to provide cost estimates to individuals who are uninsured or who are seeking out-of-network care. Many health insurers have developed websites that allow their enrollees to compare costs across in-network providers for many health care services. Some non-profit organizations that have also developed health price transparency websites. More information on health care quality and cost is available in the Texas Health Compare section of TDI's Texas Health Options website.