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Reducing Barriers to Obtaining Health Care Records

In the 2016 legislative session, Representative Teo Zagar introduced H.554 on my behalf after I wrote to him explaining how costly it would be to obtain a copy of my health care records.  At the time Teo and I corresponded (December 2015), a copy of my records would have cost $438, which is what’s allowed by statute  ($5.00 flat fee or $.50 per page, whichever is higher).  I hope the bill will get picked up this coming session and reintroduced in the House Health Care Committee.

There’s a strong argument that consumers should be able to obtain a copy of their own records for free.  In the bill I drafted, I suggested that consumers be allowed one free copy of their records per year.  Even if a personal copy of one’s records isn’t made available for free, the cost should be reduced from $.50 per page to a rate more comparable to the actual cost that it takes to produce the records.

The $.50 per page copy fee is substantially more than commercial printing costs which are around $.10 per page and while providing one free copy may seem like an administrative burden and an extra cost on providers, it would certainly benefit the public at large for consumers to have easier access to their own medical records.  The legislature may want to emulate Vermont Public Records law by allowing for the first 30 minutes of labor to be free and to require that records be produced at actual cost.

Similar to public records law, any time there are cost barriers placed in front of consumers, these barriers make health care  generally less transparent.

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The Importance of Health Care Price Transparency

Originally published on Vermont Digger in March 2015

Gov. Shumlin has proposed a .7 percent payroll tax, the main purpose of which is to address the so-called Medicaid cost-shift. The bulk of the new revenue would be used to draw down federal matching funds thus allowing Vermont to more closely align Medicaid reimbursement rates with those of Medicare (Medicaid currently reimburses at around 60 percent while Medicare’s reimbursement rate is closer to 80 percent). Gov. Shumlin has committed that this way of addressing the cost-shift will result in a 5 percent reduction of private insurance premiums (though the Green Mountain Care Board (GMCB) is not making the same promise).

Leaving aside the important yet unanswered questions about whether the cost-shift actually exists, and if it does, the degree to which it occurs, there is ample skepticism in the General Assembly about whether the payroll tax is a good idea. While still on the table, the payroll tax may not make it to the governor’s desk this year, or ever. Consequently, the Legislature should consider alternative ideas that would reduce the impact of the cost-shift. The clearest and most plausible idea is to increase health care price transparency. Continue reading “The Importance of Health Care Price Transparency”