New Mexico Introduces Website to Track and Compare Medical Treatment Costs

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The state of New Mexico has introduced a new website aimed at increasing transparency in medical billing, a move some hope will help control rising healthcare costs in the future.

If you’ve ever faced a health issue and wondered about the cost of treatment, New Mexico state health officials have now provided a tool where you can find and compare costs that others have paid for similar treatments. This tool, called the All Payer Claims Database, was unveiled to all New Mexicans during the Legislative Health and Human Services interim committee meeting on Monday.

For example, the database reveals that a COVID-19 test in New Mexico costs an average of $33 but can go as high as $125. Users can search the database for specific medical treatments or providers, and by entering their zip code, they can see the estimated costs for their specific area, whether they live in Gallup, Clovis, Mora, Chaparral, or anywhere else in the state.

The website’s primary goal is to make medical billing more transparent and to identify trends in healthcare usage and spending. Some lawmakers believe that the data behind this website could eventually be used to help control healthcare costs across the state.

The database contains data from 160 million health insurance claims filed by nearly 1.5 million New Mexicans between January 2020 and March 2024, according to a presentation by New Mexico’s Department of Health Secretary, Patrick Allen, on Monday. State law mandates that healthcare providers, such as clinics and hospitals, as well as insurance companies, provide this data to state officials.

Healthcare providers can use the database to compare their costs and services with others, insurance companies can evaluate their expenses against a statewide average, and policymakers can use the data to understand how public funds are being used within the healthcare system, according to Allen.

Controlling Healthcare Costs

While the public-facing portal of the database is designed to answer simple questions, the full database is far more detailed and could be made available to the committee for more in-depth decision-making, Allen explained.

Senator Martin Hickey (D-Albuquerque) asked Allen if the data is being shared with the Legislative Finance Committee (LFC), which manages the state budget. He urged LFC officials to obtain the raw data from the Department of Health to better understand what is driving the rising healthcare costs and to explore ways to control it.

Hickey cited Oregon’s Health Authority’s Sustainable Health Care Cost Growth Target Program as an example, where state officials can penalize insurance companies or providers if their prices increase by more than 3% per year.

“We want to make sure we’re doing everything possible to spotlight healthcare costs so that, like other states, we can move towards that 3% target,” Hickey said. “But the LFC needs that data. They have the expertise to analyze it.”

Allen noted that while New Mexico’s Department of Health isn’t currently sharing the data with state finance officials at the LFC, “we should be able to.”

Hickey pressed Allen for a commitment to share the data, and Allen responded that it would be “subject to concluding an appropriate data use agreement.”

Hickey emphasized that lawmakers need to conduct their own analysis of public spending to validate the data and develop policies from it, rather than relying solely on the executive branch’s interpretation.

Years in the Making

The data in the New Mexico database comes from 21 private insurance companies and public health coverage programs like Medicare and Medicaid, according to the presentation given to lawmakers on Monday.

“I know from previous discussions, you all have been thinking and working on this for a really long time,” Allen said. He was appointed to his position by Governor Michelle Lujan Grisham last year.

The New Mexico Department of Health first drafted a plan for the database in 2016. The Legislature allocated funds to build the database in 2019, and state agencies began requesting data from providers and insurance companies in 2023.

Allen also mentioned that his agency will continue to work on obtaining more comprehensive data and updating the public portal, including the addition of a Spanish-language version.

The database currently does not include claims from federal public health insurance, employer-sponsored insurance, workers’ compensation, charity, self-paid, or uninsured claims.

Previous efforts by lawmakers to make healthcare costs more transparent have had mixed results. In 2019, the House of Representatives passed a bill intended to prevent patients from being charged for “out-of-network” care when they sought treatment within their insurance network. However, that bill did not make it to a vote in the Senate.

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