NMHealth rolls out price transparency tool
SANTA FE, N.M. — Do you know how much a normal CT scan is supposed to cost? What about a knee replacement? Or even a c-section?
The New Mexico Department of Health is making it easier to see those prices before you get the bill. NMHealth is also making it easier to see how much money you could save getting the same procedure at different hospitals.
“This is an effort to pull back the curtain on health care costs,” NMHealth Secretary Patrick Allen said.” “That’s not to say that that there should never be differences in prices. Lots of times there are good reasons for those differences. But if you know what those differences are, whether you’re an individual consumer or a policymaker, you can start having questions, having conversations and asking questions about why.”
The “All Payer Claims Database” officially went live on Monday after nearly a decade of behind-the-scenes work. It includes more than 160 million insurance claims collected from 2020-24. It also includes other payment information to give new Mexicans a snapshot of how much health care costs in our state.
“They’ll be able to go into the website, and they’ll be able to search for, ‘What do different hospital systems and healthcare providers charge for knee replacement surgery?'” Secretary Allen said.
These are just the typical prices, of course. You’ll notice many procedures listed in the database specifically note “without complications.” That can significantly affect the final bill.
The benefits for patients is obvious but Allen says the database also includes crucial information for state leaders.
“Let’s say we know that in a particular part of the state. There’s a whole bunch of demand for services, but they’re getting them somewhere else. Well, can we find a way to get those services in that part of the state,” Allen said. “Legislators and their staff and health agencies are all now able to use this data in a way to try to get what we call the triple aim of better care, better health, and at lower cost.”
The new database is available right now. Secretary Allen told state lawmakers this week that NMHealth is still working to add even more data. There are plans to provide a Spanish-language version in the future.