Overview
During the audit period, CHIA did not publicize the availability of its consumer health information website, CompareCare. Specifically, CHIA officials informed us that it had not advertised the CompareCare website since its launch in 2018. We also found that the landing page on the CompareCare website directs users to visit CHIA’s commercial health insurance company’s website for more accurate healthcare cost information. However, in order to view healthcare cost data on commercial health insurance websites, users must be enrolled in a commercial health insurance plan, which serves as a barrier to residents who seek this information.
CHIA cannot fulfill its obligation to assist healthcare consumers in Massachusetts with making informed decisions regarding their healthcare if it does not actively publicize the availability of the CompareCare website.
Authoritative Guidance
Section 20(a) of Chapter 12C of the General Laws states,
The center, in consultation with commission, the executive office of health and human services, the department of public health and such other agencies or authorities as it deems appropriate, shall maintain a consumer health information website. The website shall contain information comparing the quality, price and cost of health care services. The website shall also provide information about provider and payer achievement of cost benchmarks and growth goals. The website may also contain general health care information as the center considers appropriate. The website shall be designed to assist consumers in making informed decisions regarding their medical care and informed choices among health care providers. Information shall be presented in a format that is understandable to the average consumer. The center shall publicize the availability of its website.
Reasons for Issue
CHIA officials informed us that, on any given day, the CompareCare website receives low web traffic. Additionally, CHIA officials told us that they did not prioritize promoting the CompareCare website because healthcare consumers can get more accurate healthcare cost estimates from commercial insurance companies.
We note here that law requires this website to assist consumers in “comparing the quality, price and cost of health care services.” CHIA is failing to meet this statutory requirement by forcing consumers to visit each commercial insurance company to seek information and then develop their own comparisons. Its reliance on self-published insurance company information may result in consumers relying on incomplete or inaccurate information or increase the likelihood that consumers make errors in developing and interpreting their own cost and quality comparisons.
Recommendations
- CHIA should promote the CompareCare website to the public in order to assist in meeting its legal obligation of assisting healthcare consumers with making informed decisions regarding their healthcare.
- CHIA should ensure that information found on the CompareCare website is current, accurate, and accessible for Massachusetts residents.
Auditee’s Response
The primary legislative intent of requiring CHIA to produce a consumer transparency site was to support consumer shopping. However, during the 18-months CHIA took to solicit input on the site development, it became clear that true “shopping” sites for medical procedures can only be offered by health plans, because only a health plan can determine a person’s out-of-pocket costs, which are a function of their specific coverage, the status of their deductible, and other cost sharing considerations. In fact, the single largest objection from health plans and provider organizations to the proposed website was that it would mislead patients by showing something other than what patients would have to pay. Payers and providers were very pointed in their concerns that they would be fielding calls from confused members and patients wanting to know why they were charged something other than what the state website said. The limitations of the CompareCare website for consumer shopping purposes have informed our approach to any promotional activities. CHIA believes that CompareCare still fulfills the primary purpose for which it was ultimately designed: providing general information on comparative prices for common health care services and provider quality, facilitating informed conversations between patients and their providers and insurers about health care choices, and helping consumers resolve common problems with health care.
CHIA continues to regularly update CompareCare to include the best data available at the time. Two separate updates were made to CompareCare 18 months apart during the performance audit period: one in December 2021 and another in June 2023.
Auditor’s Reply
In its response, CHIA states that limitations of the CompareCare website for consumer shopping purposes have guided its approach to promotion of the website. While we acknowledge that CHIA is limited by the data that is provided to it from health insurers, this still should not limit its ability to promote the CompareCare website to the public, as required by law. We also note that the states of Texas and California provide helpful information on their websites, with Texas (https://rates.texashealthcarecosts.org/) providing comparative information on the costs of procedures and California providing comparative costs for health insurance plans (https://apply.coveredca.com/lw-shopandcompare/).
| Date published: | January 3, 2025 |
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