Massachusetts insurers need to beef up price transparency efforts

The three biggest insurers in Massachusetts--Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim and Tufts Health Plan--should all improve their price transparency efforts required under state law, according to an evaluation from advocacy group Health Care for All (HCFA).

The Massachusetts insurers have been at the forefront of a trend to help consumers price medical procedures and services. But although they're complying with the state's price transparency law by disclosing the prices they pay for services and procedures, their cost-estimating websites aren't actually effective at helping consumers make informed choices, HCFA says.

"There was an awful lot of room for improvement," HCFA Executive Director Amy Whitcomb Slemmer told The Boston Globe. "Not one [of the websites] was intuitive."

One of the biggest problems HCFA found was that the insurers' websites confused consumers. Tufts and Harvard Pilgrim, for example, didn't include information about costs for inpatient procedures. And Blue Cross provided estimates of the total service cost but didn't always specify exactly how much the member would pay.

Blue Cross' website lacked any information on behavioral costs and prescription drugs. And on Tufts' website, a search for "MRI chest" gets no information because you have to search for "MRI of the chest."

"It's a work in progress," Bill Gerlach, Blue Cross' senior director of consumer engagement solutions, told the Globe. He explained that the insurer has already made "significant enhancements" to the information that will be online by the end of the year.

"We're trying to really empower consumers to be better healthcare consumers," he said. "This stuff is new. It's going to take time to get them up to speed."

But Barbara Anthony, who championed the state's transparency initiative, said it isn't enough for insurers to just publish prices. They must make the information easy to find and use as well as inform the public about it.

"You cannot build it and expect people to come. You must give them a road map," Anthony, who is now a senior fellow in healthcare with the Pioneer Institute, told the Globe.

To learn more:
- here's the HCFA evaluation
- read The Boston Globe article


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