Insurers ramping up price transparency efforts


Insurers in Massachusetts are on the forefront of a growing trend to help consumers price medical procedures and services, as well as find specialists and other doctors, reported The Boston Globe.

The move comes in response to a first-in-nation law  the state passed last year to cap medical spending, including requiring insurers to provide price information for their members as of Oct. 1, FierceHealthPayer previously reported.

"This is a giant step forward for the transparency agenda," Eric Schultz, CEO of Harvard Pilgrim Health Care, told the newspaper. "It creates a competitive force that hasn't existed in the healthcare industry."

Harvard Pilgrim will launch an online software application this spring called "Now iKnow," which ranks doctors and hospitals based on cost and quality. The online app will give members options, including cost estimates for a procedure and the amount already spent toward their deductibles, that are specifically based on their health plan.

Meanwhile, Blue Cross is rolling out a new cost estimator tool called "Find a Doctor" to help its members find providers and compare out-of-pocket expenses for more than 100 medical services. It's also preparing a "very plain English version" of its explanation of benefits form.

"There are products structured now with different levels of cost sharing, and members want to know where they can find a quality provider and how much it's going to cost them," said chief operating officer Bruce Bullen. "We have an obligation to provide that information to members."

And Tufts Health Plan is working on its own cost estimator to help its members better understand all the different types of health plans available. New insurance products, including tiered network plans, limited network plans and high-deductible plans, require a higher level of understanding, Derek Abruzzese, vice president of product and strategy for Tufts, told the Globe.

"The healthcare market up until now has been very different from other markets in the lack of transparency," he said. "It's easier for people to know what a television costs."

To learn more:
- read the Boston Globe article

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