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Healthcare.gov website give consumers a streamlined tool to search for and compare private and public health insurance plans, compare information on hospital quality, view the patients bill of rights, and learn ways to prevent illness.

NH Healthcare Costs

“Health care spending in New Hampshire increased dramatically. Spending on hospitals increased by almost one half ($1.4 billion) from 2000 to 2007, while spending on physician services rose by more than one third ($600 million) from 2000 to 2007. Pharmaceutical spending has doubled from 2000 to 2007.”

18% of our income goes directly to healthcare costs; that’s up from 10% in 1980
Since 2000, one billion dollars has been spent on hospital expansion projects in NH
NH residents are bearing an every-increasing burden through higher premiums & co-payments in order to cost-share both private & public insurance.

The average cost of a hospital medical error is $58,766 (1) The average length of stay for patients with a hospital- acquired infection was 20.6 days, while the average length of stay for patients without a hospital-acquired infection was 4.5 days. The average hospital charge for patients with a hospital-acquired infection was $185,260, while the average for those patients without such infections was $31,389 (2)

Source: NH Center for Public Policy

We have very little information made available to us about the quality of care we are not only receiving, but paying a great deal for. In other words, what is all this money buying?

Below are some examples of creative steps that other states have taken to answer this question, with the intent and result of improving the quality of care while driving costs down:

I. Cost and Quality Task Forces can be made up of employers, consumers, health providers, state public health professionals, financial analysts, public policy experts and lawmakers. They publicly report hospital performance outcome data (infection, complication, mortality rates, medical errors, medication errors, etc.) and cost data. Unfortunately, most of this information is not made available in New Hampshire, but many other states do so we’ve provided links to a few of them: Pennsylvania’s, New Jersey’s, Vermont’s, & Massachusetts’s programs.

II. Employer purchasing groups signing onto The Leapfrog Group.Leapfrog works on behalf of employers to bring hospital costs down, while improving quality. The NH Purchasers Group just recently signed onto Leapfrog so we should expect to see more NH hospitals participating beginning in July, 2010. Currently, only four NH hospitals participate in Leapfrog’s patient safety survey.

You can learn more about The Leapfrog Group on our ‘Hospital Quality Ratings’ page.

"The more hospital beds there are, the more patients will be admitted to fill them."

~ Eliot Fisher from the Dartmouth Atlas Project speaking at the Families USA conference, February, 2010.

Over one billion dollars has been spent on hospital expansions in New Hampshire since 2000 (source: The NH Center for Public Policy)

III. Public reporting of hospital outcome data: New Hampshire’s Infection Reporting Law passed in 2006 and an Adverse Event Reporting Law passed in 2009. The first public infection report with hospital identifiers was released on August 17th, 2010 and can be viewed by going to the state of NH Department of Health & Human Services website.

The Adverse Events report should be available in January, 2011. We will have the link available as soon as it’s up and running. Public reporting of hospital outcome data not only provides consumers and patients with valuable information to make informed decisions; it also is proven to result in better hospital performance. Many hospitals across the country have gotten their infection rates down to ZERO & are reducing serious medical errors, in part due to public reporting.

Check our legislation page for information on current bills/laws affecting consumers and patients.

IV. Requiring hospitals and insurers to be more transparent about the cost of doing business.

V. Using employers and purchasing groups' leverage to implement insurance company pay-for-performance programs.
Many insurance companies are taking Medicare’s lead of not paying for preventable infections, serious medical errors, re-do surgeries due to errors or infections, and several other complications. This can save money, while at the same time providing financial incentives for hospitals to invest in patient safety initiatives like improved staffing, training, computerized physician and medication ordering systems, preventing falls, using checklists, hand washing and infection screening and prevention measures.

Both the Senate and House Bills being proposed for federal healthcare reform have either pay-for-performance and/or public reporting requirements in them as a means to drive costs down. However, many states are implementing these measures already to gain control over costs on a local level instead of waiting for reform efforts, which could take several years to implement.

NH HEALTHCARE COSTS: INFORMATION & RESOURCES

NH HEALTH COST

This site is for consumers and employers to look up costs of common procedures and treatments, based on the health insurance you have. Also has out-of-pocket charges for those without insurance. To be truly consumer friendly, we’d like to see this site have costs listed by hospital, surgical center, lab and diagnostic center for comparison purposes. The inability to compare prices is another factor that drives up the cost of care. But, we’re glad that the Insurance Commissioner launched this site; it’s a good start.

NH PRICE POINT

This site, developed by The NH Hospital Association allows users to search hospital charges for various treatments and surgeries. Provides information for all New Hampshire hospitals, all services, and the average length of stay (physician fees not included). User friendly and easy to navigate. Users can even look up information by the ten most common types of hospitalizations and to it's credit, it provides the cost difference between those surgeries 'with' and 'without' complications so that patients can have valuable discussions with their physician about how best to avoid complications (because they add longer hospital stays and significant costs).

Imagine going to a restaurant that had no prices on the menu...Or a car dealer that had no sticker prices. In healthcare, we often go on blind faith for both cost and quality.

THE NH CENTER FOR PUBLIC POLICY

The Center does independent, non-partisan research on a variety of topics affecting our state. Access useful reports on healthcare costs and utilization in New Hampshire. Go to the home page and click on the link that says ‘NH’s Healthcare System’.

THE DARTMOUTH ATLAS PROJECT

Twenty years of research has shown that in the Medicare population, the over-utilizatoin of healthcare (and the associated costs) is not really patient-driven, but instead it is directly tied to variations in how physicians practice based on local influences like the availability of hospital beds, imaging centers and other high-tech advancements, along with a perverse payment system that rewards providers for ordering tests and doing procedures rather than spending quality time with patients.

Citations
(1) M. M. Mello, D. M. Studdert, E. J. Thomas, et al., Who Pays for Medical Errors?: An Analysis of Adverse Event Costs, the Medical Liability System, and Incentives for Patient Safety Improvement, Journal of Empirical Legal Studies December 2007 4(4):83560

(2) Pennsylvania Heath Care Cost Containment Council 2006 Annual Report on Hospital Acquired Infections
www.phc4.org/reports/hai/05/docs/hai2005report.pdf