Last year, New Hampshire was one of just two states to get an "A" on a national "report card" that measures consumer access to health care cost information.
This year, the state got an "F."
The New Hampshire Insurance Department's nhhealthcost.org website has been down since the beginning of the year. The site posts cost information for about 42 medical procedures and more than 100 providers, including all 26 acute-care hospitals as well as some radiology groups, ambulatory surgical centers and primary care physicians.
There's a new contractor compiling the insurance claims data used to calculate those costs, and there's been a delay in getting "a clean and complete data set," according to Tyler Brannen, health policy analyst with the Insurance Department.
And that was enough to earn New Hampshire a failing grade in the 2014 Report Card on State Price Transparency Laws, a joint project of Catalyst for Payment Reform and the Health Care Incentives Improvement Institute.
The state even got singled out in the report's introduction: "Unfortunately, New Hampshire - a state that received an A in last year's Report Card - dropped to an F this year because its website is inoperative and may remain so for an extended period."
Brannen said the site was taken down in mid-January because the price information posted was too old to be helpful to consumers. The state had switched to a new contractor, Seattle-based Milliman, in mid-2012.
Brannen said the timing of the CPR's report was unfortunate. "It's the ultimate example of 'the dog ate our homework.'"
Brannen said the Insurance Department is "very close" to getting the claims data it needs to make the new price calculations.
He estimated the website will be back up in June and will include additional features to help consumers compare the costs of procedures and office visits.
The groups publishing the transparency report card emphasized the importance of unbiased data to help consumers make informed health care decisions. That's something New Hampshire has done since 2006, Brannen said, by collecting actual claims data from health insurers.
"We're not relying on health care providers to tell us how much things cost," he said. "We're actually looking at what was paid."
Brannen noted the state did get a "B" grade for its laws and regulations regarding health care transparency. RSA 420-G:11-a requires the New Hampshire Department of Health and Human Services to develop a "comprehensive" health care information system and to publish the data for public access.
Had the website been up when the CPR report was prepared, Brannen said, New Hampshire would probably have received "at least a B" as an overall grade.
Meanwhile, with the website down for the past few months, Brannen has gotten calls from consumers, patient advocacy organizations and others asking when the new cost data will be posted. "I have heard from a lot of people who I had no idea were using the website," he said.
That includes the city of Nashua, which "wanted to use it for their employee health insurance selection."
Brannen said there's an upside to the failing grade in the latest report card: "I think it demonstrates the value of our (nhhealthcost.org) website to the effort around price transparency in the state.
"Once we have it back up and make some needed improvements, hopefully we'll be at the top of the scale."