Hospital Financial Transparency
NASHP’s model legislation identifies what data must be collected, which hospital documents should be used to obtain the information, and underscores that a state agency or office must be responsible for analyzing the data. NASHP also provides a reporting template to help states implement the law and collect the information needed to evaluate the vitality of a state’s hospitals.
Model Legislation: Model Act to Ensure Financial Transparency in [Name of State]’s Hospitals and Health Care Systems, August 2020.
Model Reporting Template: Hospital Financial Transparency Report Template, August 2020. Download this reporting template to use or adapt to capture the necessary data to implement the hospital financial transparency law.
The Access Project: A Community Leader’s Guide to Hospital Finance, 2020. This report, prepared by Sarah Gunther Lane, MS, Elizabeth Longstreth, BA, Victoria Nixon, MS, and Nancy Kane, DBA, provides an overview of the key questions policymakers can ask to understand hospital financial performance, including background on hospital revenues and expenses, sources of financial information, and evaluations of financial health.
The act requires annual reporting of facility fees charged or billed by health care providers, delegates implementation authority to a relevant state agency, and provides three enforcement mechanisms:
- An annual facility fee audit by the relevant state agency;
- A private right of action for consumers; and
- Administrative financial penalties against health care providers for violations.
State Policies to Address Vertical Consolidation in Health Care, August 2020. This report by Erin Fuse Brown, JD, MPH, explores the increased financial pressure for vertical consolidation, its financial impact on states and consumers, and what policies states can implement to address the coming wave of vertical health care consolidations.
Combat Rising Health Care Costs by Limiting Facility Fees with New NASHP Model Law, August 2020. This blog explains how prohibiting site-specific facility fees and requiring annual reporting of facility fees can lower health system costs.
State Purchasing Pool Buy-in
Q&A: Prescription Drug State Purchasing Pools and Buy-in, January 2020.
NASHP Proposal for a State Purchasing Pool for Prescription Drugs, October 2019. This white paper provides a roadmap to help states navigate legal issues and implement a state purchasing pool.
Model Pharmacy Benefit Manager Contract Terms Help States Achieve Prescription Drug Savings, January 2020. This blog explains how establishing favorable PBM contract terms can be a state’s first step toward leveraging additional savings through a second strategy – implementing a state purchasing pool for prescription drugs.