How insurers can make transparency tools more consumer-friendly

To make transparency tools more useful for their members and the public, health plans may want to consider narrowing down how many quality measures they rely on and making other consumer-friendly changes, according to an article from Employee Benefit News.

The need for transparency is greater than ever, as the considerable cost variation for procedures can have negative financial consequences for both individuals and employers, as well as have serious implications for the sustainability of a U.S. healthcare system. Price transparency tools are particularly important to insurers because they can help lower procedures' market price.

But among consumers there's limited uptake for price and quality transparency tools available from insurers, in part because this information is difficult to understand, Elizabeth Mitchell, president and CEO of the Network for Regional Healthcare Improvement, tells the publication. 

Indeed, while about 90 percent of insurers submit data to the Department of Health and Human Services' Healthcare Effectiveness Data and Information Set, the 71 measures it includes may be too many, according to the article. What's really needed, Mitchell says, is "a small set of really high impact quality measures that everyone agrees are most important."

Rick Gundling, the vice president of healthcare financial practices for the Healthcare Financial Management Association, goes further, telling Employee Benefit News that the list should consist of five domains of care most important to patients.

The article also suggests that health plans should widen access to their data to more than just their members--in particular, they should include physicians as key stakeholders. They also may want to establish a consumer review platform where patients can give honest feedback about procedure costs and quality of care for other patients to access.

To learn more:
- read the article

Suggested Articles

A new CMS report estimates that premiums for the second-cheapest silver tier plan will decline by 2% on HealthCare.gov next year.

Premiums on the ACA's exchanges for 2021 are expected to rise by about 1% as insurers struggle to figure out the impact of COVID-19, KFF report finds.

​​​​​​Global healthcare funding soared in the third quarter, hitting a new record of $22 billion. Digital health investments also reached new heights.