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The state of New Mexico has launched a website with the purpose of making medical billing more transparent. Some hope the data behind the website will help them control health care costs in the future.
If you’ve ever had a health issue and wondered how much it might cost to treat it, New Mexico state health officials have launched a website where you can find and compare costs that others have already paid for it. It’s called the All Payer Claims Database.
It was introduced to all New Mexicans on Aug. 26 during the Legislative Health and Human Services interim committee.
For example, in New Mexico a COVID-19 test costs $33 on average but can cost up to $125, according to the database.
You can search the database for a specific medical treatment or by a specific provider. Add your zip code and you can see what the database says it would cost for anyone that lives in Gallup, Clovis, Mora or Chaparral. Really, anywhere in the state.
The website’s purpose is to make medical billing more transparent and identify trends about how much people are using and paying for health care. Some lawmakers hope the data behind the website will help them control health care costs in the future.
The database contains data from 160 million health insurance claims made by nearly 1.5 million people in New Mexico between January 2020 and March 2024, according to a presentation by the state’s Department of Health Secretary Patrick Allen.
State law requires providers like clinics and hospitals, and payers like insurance companies to hand over the data to state officials.
Providers can use the database to compare themselves to others, insurance companies can use it to compare their costs to a statewide average, and policymakers can use it to understand how putting public money in a particular part of the health care system will work, Allen told the committee.
Controlling health care costs
While the public-facing portal tries to answer more simple and straightforward questions, the full database is much more detailed and could be made available to the committee to help them make decisions, Allen said.
Sen. Martin Hickey (D-Albuquerque) asked Allen if he’s sharing the data with the Legislative Finance Committee, which controls the state budget.
He asked Legislative Finance Committee officials to ensure they get all of the raw data from the state department of health, so they can eventually figure out what’s driving the rising costs of health care and try to find ways to control it.
Hickey pointed to the Oregon Health Authority’s Sustainable Health Care Cost Growth Target Program as an example, where Oregon officials can penalize insurance companies or providers whose prices increase by more than a target rate of 3% per year.
“We want to be sure that we’re doing everything we can to put the spotlight on costs in care so that we can, as in other states, succeed in getting toward that 3%,” Hickey said. “But LFC has to have that data. They have the talent to be able to do the analysis.”
New Mexico’s Department of Health isn’t sharing the data with state finance officials at the LFC, Allen said, “but we should be able to.”
Hickey pressed Allen to commit to sharing the data, and Allen said it would be “subject to conclude an appropriate data use agreement.”
Lawmakers need to do their own analysis of how public money is being spent so they can validate it and make policy from it, Hickey said, “and not just depend on the executive’s interpretation of it.”
Years in the making
The New Mexico data comes from 21 private insurance companies and the publicly run health coverage systems Medicare and Medicaid, according to the presentation to lawmakers on Aug. 26.
“I know from previous discussions, you all have been thinking and working on this for a really long time,” said Allen.
Gov. Michelle Lujan Grisham appointed him to the post last year.
The New Mexico Department of Health wrote an initial plan for the database in 2016, the presentation states. The Legislature set aside money to build the database in 2019, and state agencies asked for the data from providers and insurance companies in 2023.
Allen said his agency will be working to get more complete data, and update the public portal to add a Spanish version.
The database does not include claims made under federal public health insurance, employer-sponsored insurance, workers’ compensation, charity, self-paid or uninsured.
There have been other attempts by lawmakers to make health costs more transparent.
In 2019, Lujan Grisham signed a bill that prohibits providers from submitting a surprise bill for “out-of-network” care even when the patient went somewhere in their insurance network.
Source New Mexico is part of States Newsroom, the nation’s largest state-focused nonprofit news organization.
