Pioneer Institute Study: MA Health Insurers Have Made Good Progress in Price Transparency, But Significant Work Remains
A
Online cost estimator tools give consumers/plan members online information about a range of information for outpatient and many inpatient procedures. These tools display the amount that has to be paid by consumers to any particular provider, how much the plan pays the provider, and information about provider quality. Consumers can compare several providers at the same time.
"Price transparency can help initiate reforms that reduce healthcare costs and allow market forces to drive patients to lower-cost, higher-value providers," said
A 2012 state law required health insurers to develop online cost estimator tools by
The same law also requires hospitals and doctors to provide consumers with prices of services upon request. Previous Pioneer studies showed very poor compliance by
As a follow up to the HCFA study, in late 2017, Pioneer assessed the same carriers' performance and found their tools more user friendly. They cover between 700 and 1600 procedures, a vast improvement over the initial numbers of procedures available in 2015. Importantly, Pioneer found that all three carriers are embracing incentive/reward programs to attract workers at entities with 250 or more employees to lower-cost, high-value providers. Pioneer's study was done with the full cooperation of the carriers.
Under incentive/rewards programs, employees are rewarded by either small or no co-payments or cash rewards from
Both the HPHC's and THP's tools are a significant improvement over their initial cost estimator tools. After their common vendor pulled out of the market, the carriers had to entirely revamp their tools. The results are new, easy-to-navigate online tools which display out-of-pocket consumer costs, the remaining deductible, and quality metrics.
Since 2015, BCBS has made several improvements that make its product more consumer friendly: by simply changing the name of its tool from "Find a Doc" to "Find a Doc and Estimate Costs," by making the tool much more prominent on its website, and clearly showing both out-of-pocket costs and remaining deductibles. BCBS also has an improved website for consumers.
Despite significant progress, however, deficiencies remain. The carriers had about 297,000 aggregate inquiries on their cost estimator tools from early 2014 through 2017, compared to a potential market of at least three million people that the three carriers cover.
"The number of aggregate inquiries shows that carriers still have a lot of work ahead to achieve price transparency's potential to rein in healthcare costs," said
In 2015,
HPHC's and Tufts' estimator tools still don't provide cost data on many behavioral health procedures.
The BCBS site is compatible with online translation tools, but none of the carriers' cost estimator tools are readily available in a language other than English.
Anthony noted that "While state government has not provided any compliance leadership for consumer price transparency, now, after overcoming resistance and a lack of support, the market is waking up to the potential benefits of price transparency and incentive programs."
Comments from
"In a rapidly changing healthcare environment, providing consumers with transparency around cost and quality information is important and will help them make informed healthcare choices," said Harvard Pilgrim President and CEO
"
"Transparency is essential among all stakeholders in healthcare to ensure that customers and employer groups can make informed healthcare decisions," said
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Read the full story at http://www.prweb.com/releases/2018/04/prweb15423055.htm
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