AHIP: How insurers can improve price transparency tools

Insurers have launched more price transparency initiatives to empower their members to become more engaged in and make more informed choices about their healthcare, according to a new issue brief from America's Health Insurance Plans (AHIP).

Based on the huge variation in medical costs, price transparency tools are important to insurers because they can help lower procedures' market price. One study showed that states with transparency websites saw a 7 percent decrease in prices for common, elective medical procedures. And price transparency tools can lead to lower claims payments, FierceHealthPayer previously reported.

Aetna has launched a widespread price transparency initiative, including a payment estimator that lets members calculate how much care would cost, based on their coverage, their specific medical conditions and the providers they choose. "Transparency is going to be particularly important when the market moves more to consumerism," Michael Palmer, Aetna's chief innovation and digital officer, previously told FierceHealthPayer in an exclusive interview.

To help make their price transparency initiatives more meaningful and beneficial to members, AHIP suggests insurers' price information should be:

  • Comparable, actionable and consumer-friendly: Insurers should use common definitions, highlight meaningful differences in prices and describe information in a clear and easy way.
  • Paired with quality information: Insurers should provide cost information alongside quality data so that consumers don't believe that high cost automatically equals high value.
  • Beneficial to consumers without anticompetitive impact: Insurers' price transparency tools should not provide "competitively sensitive information," including specific negotiated rates between insurers and providers. Instead, insurers should focus on providing helpful information such as out-of-pocket costs for specific services, cost-sharing obligations and estimated costs for a service bundle.

To learn more:
- here's the AHIP issue brief

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