New York State Department of Health Price Methodology Workgroup: Final Recommendations

New York’s consumers are feeling the impact of rising costs for health care services and out-of-pocket expenses for insurance coverage. Affordability is a common concern not only in our state but across the nation, with nearly half of U.S. adults experiencing difficulties paying their medical bills. Yet it is hard for consumers, patients, and families to find meaningful, comparative information about health care prices before receiving services. This information gap prevents New Yorkers from considering prices when deciding where to seek care and selecting lower-cost providers, if preferred.  

To complicate matters, health care prices can vary depending on a host of factors including one’s health insurance benefits, a health care provider’s location or health system affiliation, and contracting agreements between private payers and providers that have largely been hidden from public view. In response, federal and state government are prioritizing price transparency as a strategy for activating consumers, increasing competition, and potentially narrowing differences in the rates charged by providers for the same health care services.

In 2020, Governor Cuomo directed the New York State Department of Health (NYS DOH) and two other state agencies to create a consumer-friendly website, “NYHealthcareCompare,” where New Yorkers would be able to easily compare the cost, volume, and quality of health care services and procedures. The site would also provide consumers with educational resources designed to support their health care journey; and help them understand their rights and options for obtaining financial assistance, what to do about a surprise medical bill, and more.  

As early work began on NYHealthcareCompare, the NYS DOH Office of Quality and Patient Safety engaged UHF to help solicit a broad range of perspectives and advice from across New York State. UHF helped NYS DOH organize and convene a multi-stakeholder workgroup made up of participants from consumer advocacy groups, providers, payers, professional and trade organizations, foundations, nonprofits, and consulting organizations. Over the course of eight months, the workgroup deliberated on the most effective ways to develop and present meaningful and user-friendly pricing information and resources that could support common health care decisions. UHF synthesized the workgroup’s recommendations in a report for NYS DOH, which is now public.