If you've ever had a health problem and wondered how much it would cost to treat it, New Mexico health officials have launched a website where you can search and compare the costs others have already paid.
This is called the “All Payer Claims Database.”
The bill was introduced to all New Mexicans on Monday in the New Mexico Assembly's Health and Human Services Interim Committee.
For example, in New Mexico, the average cost of a COVID-19 test is $33, but it can cost up to $125, according to the database.
The database allows you to search for specific medical procedures and specific providers, and by entering your zip code, the database will let you see what the cost will be no matter where you live in the state, whether that be Gallup, Clovis, Mora, Chaparral, or anywhere else.
The website aims to increase transparency in medical billing and identify trends in how people use and pay for health care, and some lawmakers hope the data will help contain future health care costs.
The database contains data on 160 million health insurance claims submitted by about 1.5 million New Mexicans between January 2020 and March 2024, New Mexico Health Secretary Patrick Allen announced Monday.
State law requires providers, such as clinics and hospitals, and payers, such as insurers, to turn the data over to state authorities.
Allen told the committee that health care providers could use the database to compare themselves to others, insurers could compare their costs to statewide averages and policymakers could use it to understand the outcomes of putting public funds into certain parts of the health care system.
Controlling medical costs
While the public portal attempts to answer simpler, more understandable questions, Allen said the full database is much more detailed and could be used by the commission to make decisions.
Sen. Martin Hickey, D-Albuquerque, asked Allen if the data was shared with the Legislative Finance Committee, which manages the state budget.
He called on officials of the state Assembly Finance Committee to ensure they get all the raw data from the state health department so they can finally determine the causes of rising health care costs and find ways to curb them.
Hickey pointed to the Oregon Health Authority's Sustainable Healthcare Cost Growth Target program, which allows state regulators to fine insurers and providers whose prices increase above a 3 percent annual target rate.
“We want to do everything we can to shine a spotlight on the cost of care so we can get closer to 3 percent, just like other states,” Hickey said, “but LFC needs to have that data. They have the talent to do the analysis.”
The New Mexico Department of Health has not shared the data with the LFC state treasurer, but “it should be possible to do so,” Allen said.
Hickey urged Allen to share the data, which Allen said was “subject to appropriate data use agreements being put in place.”
Hickey said lawmakers needed to do their own analysis of how public funds were being spent and then use that to craft policy “rather than just relying on the administration's interpretations.”
It took years to build
New Mexico's data came from 21 private insurers and the public health insurance programs Medicare and Medicaid, according to documents presented to lawmakers on Monday.
“I know from the discussions we've had so far that you've been thinking about and working on this for a really long time,” Allen said.
Gov. Michelle Lujan Grisham appointed him to the position last year.
The New Mexico Department of Health developed an initial plan for the database in 2016. The state Legislature appropriated funding to build the database in 2019, and state agencies have asked health care providers and insurers for the data in 2023, according to the presentation.
Allen said the department will work to get more complete data and update its public portal to include a Spanish language version.
The database does not include claims from federal public health insurance, employer-sponsored insurance, workers' compensation, charity, self-paid, or uninsured sources.
There have been other attempts by lawmakers to increase transparency in health care costs.
In 2019, the House of Representatives passed a bill aimed at preventing patients from being charged for “out-of-network” care even when they visit a provider within their insurance network.
The bill died before it could reach a vote in the Senate.
