Survey: Majority of healthcare plans offer price transparency tools

surgery

The majority of health plans in the U.S. offer price transparency tools to consumers, nearly all of which include estimates for common surgical procedures, radiology services, and out-of-pocket costs, according to a survey published in the American Journal of Managed Care (AJMC).

The survey, conducted by America's Health Insurance Plans (AHIP), included responses from 43 health plans contacted between 2014 and 2015. Of those, 31 plans provided price estimator tools, and nearly half of the plans that did not have price estimator tools planned to implement them within the next 12 to 24 months.

Eighty percent of plans that offered estimation tools based their selection on common procedures and services. Nearly every plan included estimates for elective outpatient surgery, radiology services, and inpatient surgery. Fifty-eight percent of plans included cost estimates for prescription drugs and 90 percent outlined out-of-pocket costs for specific procedures.

Free Daily Newsletter

Like this story? Subscribe to FierceHealthcare!

The healthcare sector remains in flux as policy, regulation, technology and trends shape the market. FierceHealthcare subscribers rely on our suite of newsletters as their must-read source for the latest news, analysis and data impacting their world. Sign up today to get healthcare news and updates delivered to your inbox and read on the go.

However, researchers also noted that simply making cost estimation tools available does not mean members are likely to use them, and further research should look at ways of displaying pricing data that leads to better engagement and comprehension among beneficiaries.

Although price calculators are gaining popularity among consumers, some have expressed concerns about the accuracy of those estimates. Still, previous research has shown that when customers have access to pricing information, claims payments for common medical procedures go down. 

Last year, AHIP released recommendations for price transparency tools, urging health plans to include quality data alongside cost information and develop actionable, consumer-friendly data without providing "competitively sensitive information."

To learn more:
- see the AJMC study

Suggested Articles

A judge has dismissed the ongoing case between Oscar Health and Blue Cross Blue Shield of Florida over broker arrangements.

Expanding options for dental care in Medicare is a popular idea, but policymakers could take several avenues toward this goal, a new analysis shows.

Tennessee's proposal for a block grant brings a host of questions.