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Cost transparency becomes critical


The Patient Protection and Affordable Care Act’s provisions for states to implement health insurance exchanges, combined with employers shifting more responsibility for healthcare costs to employees, is expected to create a greater demand for healthcare cost transparency.

The stars may be aligning to shine a light on a need for healthcare cost transparency. The Patient Protection and Affordable Care Act (PPACA), health insurance exchanges and a trend toward higher-deductible plans all depend, to some degree, on consumers being able to compare healthcare costs.

“Our healthcare system has always been unusual in that consumers have not had the resources to understand the cost of the services they receive, yet typically are asked to finance at least some part of that care,” says Robin Gelburd, president of FAIR Health, Inc., which provides healthcare charge information. “While making the decision to seek medical care is clearly different from most other purchasing decisions, it is not reasonable to suggest that cost should play no role in such decisions.”

The number of employers offering various forms of high-deductible health plans has increased, and is expected to continue to do so, which ties healthcare spending decisions more directly to costs. Gelburd says the trend toward high-deductible and higher co-pay plans will make consumers take more interest in the cost of care they receive.

As the debate on how to lower healthcare costs took center stage during the PPACA’s journey into law, responsible spending by consumers became a hot topic. State health insurance exchanges will fuel an even greater need for healthcare cost transparency, Gelburd says.

“When states begin implementing the health insurance exchanges in 2014, millions of Americans will have their first opportunity to choose a health plan that best suits their health needs and financial constraints,” she says. “As they evaluate various tiers of health plan options that embody different cost sharing requirements, they will need information on what healthcare services in their area typically cost.”

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