The Price of Healthcare in New Hampshire Affects Us All

By Patrick Miller

In the past two years, New Hampshire Local Government Center’s (LGC) HealthTrust has partnered with several other large public purchasers, including the State of New Hampshire Employee Health Benefits Program, the University System of New Hampshire and the New Hampshire School Health Care Coalition to determine ways to lower the cost of healthcare while improving quality and the health and wellness of all employees.

Cost Variations

Healthcare benefits are an increasing part of town and state budgets and, in many instances, are competing directly for wage increases and raising the attention of local taxpayers. Within the past year, there have been a number of reports released showing that New Hampshire’s healthcare costs are some of the most expensive in the nation. There are also wide variations in pricing which depend upon where a patient seeks treatment.

These reports have been released by a variety of organizations, including the New Hampshire Insurance Department (NHID), the New Hampshire Center for Public Policy Studies (NHCPPS), the New Hampshire Citizens Health Initiative (NHCHI) and the New Hampshire Purchasers Group on Health (NHPGH). One report titled Measuring the Health of the Healthcare System: New Hampshire’s Healthcare Dashboard was released to the New Hampshire Legislature by the NHCPPS and is considered a “dashboard" for a number of healthcare indicators, including cost, quality, access, public health and infrastructure.

These indicators are designed as a benchmark against the other 49 states and created to inform the Legislature and others as they consider healthcare policy. To quote from the report, “New Hampshire’s overall [healthcare system] score is hindered by poorer score values on public health (77.5 percent), access (73.1 percent) and cost (71.5 percent) … New Hampshire’s healthcare is expensive, causing New Hampshire to receive a less favorable score on that indicator." The full report may be accessed at

Hospital Comparisons

A second report titled New Hampshire Acute Care Hospital Comparison was released by the NHID and co-commissioned by the NHCHI and NHPGH. It provides a variation analysis of pricing differences between New Hampshire’s hospitals for inpatient care and a “market basket" of services for outpatient care.

The report identified that there is a 71 percent differential in pricing between the least expensive hospital and the most expensive hospital. As shown in the chart on page 21 (2006 Combined Inpatient and Outpatient Cost Index By NH Hospital), Speare Memorial Hospital in Plymouth was noted to be 19 percent below the average of all New Hampshire hospitals while Exeter Hospital was 52 percent above the New Hampshire average.

The full report may be downloaded from the NHCHI’s website at

Empowered Employees

There are many things that you as an employee can do to help bring the cost of healthcare down. They include the following:

•Ask your physician to prescribe generic drugs for you.
•Inquire about whether an x-ray might be just as effective as a CT scan before having the latter.
•Request second opinions before surgeries.
•Find out what the cost of procedures are at different hospitals before you have them.
•Enroll in health and safety classes.
•Adopt healthy lifestyle changes that will not only make you feel better but live longer.

Provider Report Card

In the coming months, LGC’s HealthTrust will be publishing a report card on healthcare provider costs, quality and patient satisfaction. It will be the start of a series of new value-added communications being provided to all public employees and their families to help them take charge of their health and better address the issue of rising healthcare costs.

These combined efforts are being undertaken in order to promote transparency of New Hampshire’s healthcare system while helping to make our citizens healthier and lower their related medical costs.

Patrick Miller, MPH is a Senior Staff member of the New Hampshire Citizens Health Initiative and Research Associate Professor at the University of New Hampshire.