Top payers join to offer pricing transparency to patients

May 16, 2014

The Healthcare Cost Institute is joining with insurance companies Aetna, Humana, and UnitedHealthcare to launch a website that aggregates price and quality data to help patients with healthcare decisions starting in 2015.

The Health Care Cost Institute (HCCI) is joining with insurance companies Aetna, Humana, and UnitedHealthcare to launch a website that aggregates price and quality data to help patients with healthcare decisions starting in 2015.

The website will feature detailed cost transparency and analysis tools provided by the participating insurance companies. It may also include pricing information from other commercial health plans, as well as Medicare Advantage and Medicaid plans, depending on the state. HCCI is expecting that more private insurers will join the information portal before the launch in early 2015.

“Consumers, employers and regulatory agencies will now have a single source of consistent, transparent health care information based on the most reliable data available, including actual costs, which only insurers currently have,” said David Newman, executive director of HCCI. “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.”

With healthcare costs estimated to reach $4.7 trillion by 2020, more consumers are demanding transparency in pricing and payment information from healthcare providers. In April, Medicare released payment data on more than 800,000 physicians, though many physician advocacy groups questioned the usefulness of the information without the context of quality of care and value to patients. The Sunshine Act, a provision of the Affordable Care Act, requires pharmaceutical and medical device companies to report financial relationships with physicians that will be available online in September.

Reid Blackwelder, MD, FAAFP, president of the American Academy of Family Physicians, says that having insurers release the information in an easy-to- understand format also benefits consumers, unlike the Medicare physician payment information that was released earlier this year.

“More transparency is always going to be positive, especially when patients are better informed. Many times when patients change insurance carriers, prices of prescriptions and care change. This way they are better informed,” Blackwelder says. “We still need good context and a dependable look at payment and cost data.”

Neil Kirschner, PhD, senior associate of regulatory and insurer affairs for the American College of Physicians, says that matching the price and quality data is a better way to help patients make healthcare decisions. “The data should be reliable and validated. They should report how they came up with the data, and make sure when it is published it is understandable and useful, but also the limitations,” he says.