Health Plans Will Publish Pricing Data
A new portal intended to give consumers specific information about what their care will cost them has obtained the rare cooperation of three of the nation's biggest health insurers.
Minnesota-based United HealthCare, Connecticut-based Aetna and Kentucky-based Humana have all agreed to share pricing data with the Health Care Cost Containment Institute, a Washington, D.C.-based organization that researches cost issues.
HCCI announced on Wednesday that it would use the enormous amount of price data compiled by the three carriers to create a free portal for consumers that allow them to shop among the insurers and providers for the price of receiving care. Quality data would also be included. The portal is expected to begin operating in 2015.
"Consumers, employers and regulatory agencies will now have a single source of consistent, transparent healthcare information based on the most reliable data available, including actual costs, which only insurers currently have," said David Newman, HCCI's executive director. "Voluntarily making this information available will be of immeasurable value to consumers and other health system participants as they seek to manage the cost and quality of care.”
Newman noted that the ever-rising rising cost of healthcare delivery – it is expected to cost nearly $5 trillion a year by the end of the decade – is the impetus for the portal. In addition to the using the data from the commercial plans, the HCCI said it would also seek permission from regulators from each state to publish Medicare Advantage and Medicaid managed care price data.
Although the three participating health plans are fairly small players in California, they still enroll about 1.4 million residents in commercial and Medicare plans. UnitedHealth is the largest, with about 860,000 enrollees, followed by Aetna's 560,000. Humana has about 25,000 enrollees, virtually all in Medicare Advantage enrollees.
Officials with UnitedHealth and Aetna did not immediately respond to requests seeking comment on Wednesday.
The issue of price transparency for consumers has come to the fore in recent years not only as costs continue to rise, but as a larger number of individuals either have to purchase their own insurance or have to pay for more of their care directly out of pocket.
Although many companies have launched in recent years to provide some pricing information for consumers, there has been a concern among both providers and payers that disclosing too much specific information could put them at a competitive disadvantage.
Hospitals have also chafed against releasing information they consider inimical to how they do form contracts with insurers. SB 1300, the last major legislative effort to provide transparency on hospital pricing at the health plan level, died in the Senate after the powerful California Hospital Association lobby raised objections.
But a study performed by the Center for Studying Health Policy Change and released by the Gary and Mary West Health Policy Center today concluded that if all states operated all-payer claims databases, it would cut healthcare costs by as much as $55 billion over the next decade in part by “increasing pressure on high-price hospitals to reduce or justify their prices,” the West Center said in a statement.
Chapin White, a senior researcher with the Santa Monica-based RAND Corp. who is the lead author of the study, observed that “price transparency alone isn’t going to change the structural factors that support excessive spending in our healthcare system, but in concert with the transition to newer health plan designs, and newer ways of paying providers, it plays an essential role.”
