Price Transparency Tools: The Good News, The Challenges, And The Way … – Health Affairs (blog) – tools – Google News

aWith health care costs continuing to rise and employees taking on an ever-growing share of costs, it’s no wonder the market for price transparency and consumer-oriented tools and solutions continued to grow in 2013. Well over a dozen independent vendors and all the major health plans now offer some type of price transparency tool or “solution” for employers and purchasers, and more join their ranks each year, aided by venture capitalists’ investments.Policymakers are jumping on the price transparency bandwagon too; on the heels of the release of the HCI3/CPR 2013 Report Card on State Price Transparency Laws, many state legislatures took up the issue of price transparency in 2013 and attempted to pass better laws to empower consumers. But do today’s products help consumers find comprehensive and comprehensible information on health care costs and quality? Are employers finding them they useful—and usable—when trying to educate and empower consumers with the hope of reining in health care spending?Last November, Catalyst for Payment Reform—a nationwide nonprofit coalition of large employers and other health care purchasers–issued a call to action to health plans, providers, and policymakers. The ask? Help support greater price transparency!  Our Statement outlined steps plans and providers could take, including sharing claims data and removing gag clauses. In addition, we issued Comprehensive Specifications for the Evaluation of Transparency Tools, thereby offering employers and purchasers general guidance on features tools should have if they’re to be useful for consumers.This fall, CPR took a closer look at the more established products in an attempt to answer the question: Are these tools and solutions evolving to become more useful for consumers and employers? We examined fee-based online tools and telephonic solutions available from independent vendors for purchasers and employers, as well as the tools the major national health plans offer freely to their members. We summarize our findings in a new report.Signs Of ProgressThe good news: Most of the tools and solutions we examined are much improved from the products we had just a few years ago, and we have made progress when considering the statement we issued just one year ago. Most products today have physician and hospital information in one place, they have at least some information on both price and quality, and they offer the ability to compare providers by price and quality. Some allow consumers to understand the price for a full episode of care, such as the stages of pregnancy, including delivery. Today, many products estimate both the full price of care as well as consumers’ out-of-pocket costs.CPR’s 2013 National Scorecard on Payment Reform found 86 percent of plans reported having a cost calculator tool that shares the member’s out-of pocket costs.  This is a major step forward. Seven years ago when the California HealthCare Foundation released a report on price transparency products, most did not display out-of-pocket costs. The price estimates today’s products offer to consumers may also be more reliable; most use some form of claims data, as opposed to regional or other averages.More good news: In recent conversations with several plan and price transparency vendors, many noted that gag clauses were becoming less of a concern, thereby helping consumers gain more accurate price data. Efforts by employer and consumer coalitions to shine light on this issue have been quite helpful. And providers themselves are becoming more supportive of the very concept of transparency. For example, the Healthcare Financial Management Association has a new task force devoted to the subject.Remaining ChallengesBut some of these products need work before they meet the needs of consumers. Some fall short when it comes to how well they help consumers understand value: high-quality care at the lowest cost. The best tools and solutions help consumers understand that more expensive care doesn’t mean better care, and that more efficient care can be of great benefit to patients—it can indicate fewer unneeded tests and procedures and less time wasted in the doctor’s office. The best tools and solutions will help consumers truly understand the meaning of value, why they should care, and how they can identify high-value providers.For such products to help rein in health care spending, consumers also need to understand their out-of-pocket costs, the full costs of their care, and why both matter. From the perspective of employers and other health care purchasers, better tools will show a consumer both the full price and their share of cost and explain why both are important in the long term. Similarly, to help consumers and employers or other purchasers save money, the best tools and solutions should help steer consumers away from unneeded care and toward lower-cost alternatives. With public education campaigns like Choosing Wisely gaining strength, tools and solutions can build on this messaging to deliver timely prompts.Unfortunately, the familiar phrase “if you build it they will come,” does not apply to price transparency products. CPR’s 2013 National Scorecard on Payment Reform revealed that 98 percent of health plans say they offer cost calculator tools, but only two percent of patient members use them. The best tools and solutions will have a strong consumer engagement strategy that encourages consumers to use the tool or service on an ongoing basis. Fortunately, several of the tools and solutions we looked at are developing—or have already deployed—engagement tactics based on leading consumer behavior research. Otherwise, consumers have little incentive to shop based on price once they meet their deductibles and realize their employers are now picking up the tab.Products need to be useful to consumers, but at the end of the day they also must be easy for purchasers and employers to deploy and maintain. To support employee health, many large employers and purchasers already have contracts in place with different vendors, ranging from wellness vendors to pharmacy benefit managers (PBMs). Health plans and price transparency vendors need to be flexible and cooperative, willing to work with other vendors to deploy their product seamlessly, from both the employer and employee perspective. For health plans, this also means allowing self-funded employers and purchasers to take their own claims data to third-party vendors when they desire to work with another entity to create a transparency tool or solution. CPR is hearing that more plans are allowing their self-insured customers to do so. Many of these arrangements are confidential for now, but large employers anecdotally are reporting movement. Our large employer and purchaser members been steadily pushing this agenda for years; It is rewarding to hear about examples of progress.The Path AheadSo we will greet 2014 having made progress, with price information more accessible and tools steadily becoming more robust. But there is more work we can all do. First, employers, purchasers, and consumers need to continue to push plans and providers so that those final hold-outs allow claims and other payment and price data to be shared unencumbered by gag clauses. We know also that state legislatures can do more to make both quality and price information publicly available. CPR recognizes organizations like the National Conference of State Legislatures (NCSL) and the National Academy of State Health Policy (NASHP) for helping them along, as well as organizations like the Health Care Incentives Improvement Institute (HCI3) that have created and shared model legislation.If we really want to help consumers make intelligent decisions about both quality and price, health plans and independent vendors need to accelerate their conversations with employers and consumers and continue to work hard on products that already show lots of promise. Email This Post  Print This PostDon’t miss the insightful policy recommendations and thought-provoking research findings published in Health Affairs. to the #1 source of health policy research.This entry was posted on Wednesday, November 20th, 2013 at 2:44 pm and is filed under All Categories, Competition, Consumers, Health Care Costs, Payment, Policy, Politics, Quality, States. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.This entry passed through the Full-Text RSS service — if this is your content and you’re reading it on someone else’s site, please read the FAQ at fivefilters.org/content-only/faq.php#publishers.Price Transparency Tools: The Good News, The Challenges, And The Way … – Health Affairs (blog)tools – Google NewsPrice Transparency Tools: The Good News, The Challenges, And November 22, 2013 With health care costs continuing to rise and employees taking on an ever-growing share of costs, it’s no wonder the market for price transparency and consumer-oriented tools and solutions continued to grow in 2013. Well over a dozen independent vendors and all the major health plans now offer some type of price transparency tool or “solution” for employers and purchasers, and more join their ranks each year, aided by venture capitalists’ investments. Policymakers are jumping…Price Transparency Tools: The Good News, The Challenges, And November 22, 2013 With health care costs continuing to rise and employees taking on an ever-growing share of costs, it’s no wonder the market for price transparency and consumer-oriented tools and solutions continued to grow in 2013. Well over a dozen independent vendors and all the major health plans now offer some type of price transparency tool or “solution” for employers and purchasers, and more join their ranks each year, aided by venture capitalists’ investments. Policymakers are jumping…Price Transparency Tools: The Good News, The Challenges, And November 22, 2013 With health care costs continuing to rise and employees taking on an ever-growing share of costs, it’s no wonder the market for price transparency and consumer-oriented tools and solutions continued to grow in 2013. Well over a dozen independent vendors and all the major health plans now offer some type of price transparency tool or “solution” for employers and purchasers, and more join their ranks each year, aided by venture capitalists’ investments. Policymakers are jumping…Price Transparency Tools: The Good News, The Challenges, And November 22, 2013 With health care costs continuing to rise and employees taking on an ever-growing share of costs, it’s no wonder the market for price transparency and consumer-oriented tools and solutions continued to grow in 2013. Well over a dozen independent vendors and all the major health plans now offer some type of price transparency tool or “solution” for employers and purchasers, and more join their ranks each year, aided by venture capitalists’ investments. Policymakers are jumping…Price Transparency Tools: The Good News, The Challenges, And November 22, 2013 With health care costs continuing to rise and employees taking on an ever-growing share of costs, it’s no wonder the market for price transparency and consumer-oriented tools and solutions continued to grow in 2013. Well over a dozen independent vendors and all the major health plans now offer some type of price transparency tool or “solution” for employers and purchasers, and more join their ranks each year, aided by venture capitalists’ investments. Policymakers are jumping…Price Transparency Tools: The Good News, The Challenges, And November 22, 2013 With health care costs continuing to rise and employees taking on an ever-growing share of costs, it’s no wonder the market for price transparency and consumer-oriented tools and solutions continued to grow in 2013. Well over a dozen independent vendors and all the major health plans now offer some type of price transparency tool or “solution” for employers and purchasers, and more join their ranks each year, aided by venture capitalists’ investments. Policymakers are jumping…Price Transparency Tools: The Good News, The Challenges, And November 22, 2013 With health care costs continuing to rise and employees taking on an ever-growing share of costs, it’s no wonder the market for price transparency and consumer-oriented tools and solutions continued to grow in 2013. Well over a dozen independent vendors and all the major health plans now offer some type of price transparency tool or “solution” for employers and purchasers, and more join their ranks each year, aided by venture capitalists’ investments. Policymakers are jumping…Price Transparency Tools: The Good News, The Challenges, And November 22, 2013 With health care costs continuing to rise and employees taking on an ever-growing share of costs, it’s no wonder the market for price transparency and consumer-oriented tools and solutions continued to grow in 2013. Well over a dozen independent vendors and all the major health plans now offer some type of price transparency tool or “solution” for employers and purchasers, and more join their ranks each year, aided by venture capitalists’ investments. Policymakers are jumping…Price Transparency Tools: The Good News, The Challenges, And November 22, 2013 With health care costs continuing to rise and employees taking on an ever-growing share of costs, it’s no wonder the market for price transparency and consumer-oriented tools and solutions continued to grow in 2013. Well over a dozen independent vendors and all the major health plans now offer some type of price transparency tool or “solution” for employers and purchasers, and more join their ranks each year, aided by venture capitalists’ investments. Policymakers are jumping…Price Transparency Tools: The Good News, The Challenges, And November 22, 2013 With health care costs continuing to rise and employees taking on an ever-growing share of costs, it’s no wonder the market for price transparency and consumer-oriented tools and solutions continued to grow in 2013. Well over a dozen independent vendors and all the major health plans now offer some type of price transparency tool or “solution” for employers and purchasers, and more join their ranks each year, aided by venture capitalists’ investments. Policymakers are jumping…Price Transparency Tools: The Good News, The Challenges, And November 22, 2013 With health care costs continuing to rise and employees taking on an ever-growing share of costs, it’s no wonder the market for price transparency and consumer-oriented tools and solutions continued to grow in 2013. Well over a dozen independent vendors and all the major health plans now offer some type of price transparency tool or “solution” for employers and purchasers, and more join their ranks each year, aided by venture capitalists’ investments. Policymakers are jumping…Price Transparency Tools: The Good News, The Challenges, And November 22, 2013 With health care costs continuing to rise and employees taking on an ever-growing share of costs, it’s no wonder the market for price transparency and consumer-oriented tools and solutions continued to grow in 2013. Well over a dozen independent vendors and all the major health plans now offer some type of price transparency tool or “solution” for employers and purchasers, and more join their ranks each year, aided by venture capitalists’ investments. Policymakers are jumping…Search tools wanting on many health exchanges –… October 18, 2013 Obamacare Abby Goodnough The New York Times 10 hours ago SHELBYVILLE, Ky. — As he was trying to sign up for health insurance through Kentucky’s new online exchange this month, Kenny Wheeler hit a wall. Mr. Wheeler, an independent sales representative with a neuromuscular disorder, had succeeded where many in other states had failed, getting through a thicket of log-in pages. But when he tried to find out whether two health plans he liked would pay…Estimating Income and Other Questions on the Health Care… October 4, 2013 By TARA SIEGEL BERNARD In the first week of the Obama administration’s health care enrollment period, consumers had questions on insuring dependent children over 26-years-old, immigrants and pre-existing conditions. Published: October 5, 2013 at 4:00AM Source: NYT Your Money http://www.nytimes.com/2013/10/05/your-money/estimating-income-and-other-questions-on-the-health-care-plan.html Patient Protection and Affordable Care Act (2010)Obamacare small-business exchanges limited to 2 providers… September 20, 2013 Madison — The new federal insurance marketplace for small businesses will have only one or two insurers in much of Wisconsin, including Milwaukee and Madison, though individual consumers will typically have twice as many options, a new list shows. It’s worth watching the number of insurers participating in the new online marketplaces being created in Wisconsin by the federal law known as Obamacare. That’s because one of the purposes of the so-called online exchanges for…Trends to Watch For in Employer Health Plans – New York… September 26, 2013 By ANN CARRNS As health insurance changes approach, higher costs for covering a spouse and children and higher deductibles are likely to affect more Americans covered on the job. Published: September 26, 2013 at 4:00AM Source: NYT Your Money http://www.nytimes.com/2013/09/26/your-money/trends-to-watch-for-in-employer-health-plans.html Health Insurance and Managed Care, Patient Protection and Affordable Care Act (2010)National Health Costs vs. Your Health Costs – New York… September 24, 2013 By ANNIE LOWREY A study shows why many individuals are feeling an ever-greater burden in health costs even as hospitals and insurers have wrung billions of dollars out of the system. Published: September 24, 2013 at 4:00AM Source: NYT Business Day http://economix.blogs.nytimes.com/2013/09/24/national-health-costs-vs-your-health-costs/ Health Insurance and Managed Care, Medicine and Health, Prices (Fares, Fees and Rates), United States EconomyThe Alphabet Soup of Health Spending Plans – New York… October 11, 2013 By ANN CARRNS Most people don’t know the difference between health savings accounts and flexible-spending arrangements. Published: October 10, 2013 at 4:00AM Source: NYT Your Money http://www.nytimes.com/2013/10/10/your-money/the-alphabet-soup-of-health-spending-plans.html Health Insurance and Managed Care, Patient Protection and Affordable Care Act (2010)Open Question: What are the costs and benefits to labelling… November 17, 2013 I’m writing a policy paper and I’ve found the immediate costs to consumers for GE labelling if consumers have to pay it all and then if they don’t. But I can’t find the amount of money consumers would save on health care by banning and labelling GE. If not those then I need to costs to not changing current laws and keeping things the same because that’s going to cost long term health care. November…Pushing Patients to Seek Value, Whatever That Is – New… November 20, 2013 By LIZZIE O’LEARY Changes in the insurance system are leading more consumers to consider what they expect in their health care and how much it is worth to them. Published: November 20, 2013 at 5:00AM Source: NYT Your Money http://www.nytimes.com/2013/11/20/your-money/pushing-patients-to-seek-value-whatever-that-is.html Health Insurance and Managed Care, Doctors, Consumer Behavior