All-payer claims database legislation receives final passage in Legislature

Legislation that would create an all-payer claims database is headed to Gov. Eric Holcomb.

The Indiana Senate on Monday voted 48-0 to approve Senate Bill 5, which would establish the database and require hospitals, outpatient surgery centers and urgent care facilities to publish average prices of services to their websites.

The House on Tuesday approved the same version of the bill, authored by Sen. Ed Charbonneau, R-Valparaiso.

The legislation requires the Indiana Department of Insurance to issue a request for information for an all-payer claims database by July 1 and a request for proposals by May 31, 2021.

The database is expected to provide cost information for specific procedures by facility name and allow individuals to shop around for the best price. Insurance companies would have to submit the data to the state, but the state cannot require companies in self-funded insurance plans to provide information. Those companies would be strongly encouraged to do so, though.

More than 20 states have some type of all-payer claims database.

Colorado’s database, which experts consider one of the best in the country, allows the public to see prices based on the facility-only costs (doctor fees not included) or the total bill for a procedure (doctor, medications, rehabilitation services, etc.).

Users can select a specific service, like a colonoscopy, and enter a ZIP code. An interactive chart then lists facilities, the distance from the ZIP code, the average price, a price range and a quality-of-care rating based on five stars.

Colorado patients can sort the list by facility name, distance, average price (low to high or high to low) and patient experience (high to low).

But the extra transparency has not resulted in health care costs dropping in states with these databases, according to studies.

Supporters of the measure say it’s a step in the right direction.

“We need to make sure we are making informed decisions and, in order to make those informed decisions, we need to have data,” Charbonneau said.

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