Scorecard: NY Health Care Has Ups, Downs

New York has the best policies in the nation for keeping out-of-pocket health care costs affordable, according to a recent state scorecard on health care affordability.

New York ranked fifth overall on the health affordability scorecard, which looked at both policies and outcomes in four areas of cost containment, according to Altarum's Healthcare Value Hub, which released the scorecard rating for 42 states and the District of Columbia.

The state also was ranked fifth for polices to extend coverage to all residents (although ninth in actual outcomes and third in outcomes for cutting out of pocket costs).

But it hasn't done as good of a job in its efforts to make health care cost less, according to the scorecard, ranking 27th for policies to reduce low-value care and 18th for polices addressing excess prices. New York did even worse on outcomes, ranking 42nd for low-value care outcomes and 40th for excess cost outcomes.

"New York has made great strides in improving the affordability and accessibility of health care in the state," said Leanne Politi, executive director of communications for the New York State Conference of Blue Cross & Blue Shield Plans. "We have the lowest uninsured rate in the country. But more can be done."

Steve Wood, director of insurance programs for ACR Health, agreed that New York has done much better at getting people covered by health insurance in recent years, leading to the highest insured rate ever. The expansion of Medicaid to cover people with higher incomes than in the past and the addition of an essential plan, covering people who earn a bit too much for Medicaid, have helped, he said.

"I think the New York State of Health (the state's health plan exchange) has been the major player in that (high insured rate) in helping people get coverage and helping them understand their benefits," Wood said. "When you have people in the community who can meet with you and show you what's available, that's a massive help. It's educating the public on health insurance and health care and also helping people find affordable coverage."

But out-of-pocket costs are still too high for some residents, Wood said. Preventive care is free; bronze and silver plans on the exchange now allow three free doctor visits a year; and the state has changed laws to end surprise medical billing and to make sure that hospitals and the doctors who work there accept the same insurance plans, he said.

But many health plans still have high deductible. Wood said many plans might have a $4,000 deductible.

"That's a lot of money," he said.

And the report noted that the average deductible for employer-sponsored health plans rose 14.5 percent in New York between 2011 and 2016.

Politi said some state actions, not covered in the report, drive up health care costs for consumers.

"When it comes to out-of-pocket costs, it's important to look at the reason why those costs are high," she said. "Out-of-pocket costs are high because the cost of policy is high. New York has some of the highest taxes in the country when it comes to health care. Increasing mandates and taxes drive up the costs."

Here's where else New York falls short, according to the scorecard:

• New York doesn't do enough to address cutting down on care that does patients little or no good. As an example, the state ranks 40th in the country for reducing the number of C-sections for low-risk mothers. The state should require validated patient-safety reporting for hospitals. And it should analyze claims and electronic health record data to determine how much money is spent on low and no-value services.

• The state hasn't adopted three recommended policies to keep health care prices down: putting price transparency rules in place; creating a permanent body to provide health spending oversight; and establishing spending targets.

Private pay prices in New York, the report noted, are 178 percent higher than Medicare prices.

Contact reporter Amy Neff Roth at 315-792-5166 or follow her on Twitter (@OD_Roth).

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