Health Insurance Giants Will Unveil Price Info In 2015

Concierge Medicine Today

By Bruce Japsen, Forbes Contributor

san diegoMAY 14, 2014 – The elusive goal to provide consumers more transparency about prices may soon be achieved via a collaborative effort of health insurance giants AetnaAET+0.04% (AET), HumanaHUM-1.5% (HUM) and UnitedHealth GroupUNH-0.97% (UNH), the three confirmed today. 

A nonprofit organization the three work with known as Health Care Cost Institute, a nonpartisan research organization, said the insurance companies will develop and provide consumers “free access to an online tool that will offer consumers the most comprehensive information about the price and quality of health care services.” Additional health plans could soon join Aetna, Humana and UnitedHealth in the effort.

The move by the insurance companies comes as more Americans gain health care coverage under the Affordable Care Act. Meanwhile, these newly insured Americans and those already with coverage are demanding more information about the cost of care as…

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2 thoughts on “Health Insurance Giants Will Unveil Price Info In 2015

  1. Pardon me, but I don’t think this price/cost transparency initiative is what it seems; let alone capable of delivering the goods as advertised. It is brilliant marketing, though.

    All it really does is to allow a glimpse into the internals of a very dysfunctional and inflationary system (the part of the system they want us to see); that being the ICD/CPT codes coupled with Evaluation/Management billing levels that for a predetermined level of reimbursement for physicians/hospitals. Indeed, it will take the focus off of the “insurers” and make it seem as if the providers are the ones setting the prices. Nothing could be further from reality. At the risk of being overly cynical, this initiative is more about hitching a ride on the price-transparency bandwagon, than it is about serious reform.

    Here are some suggestions for the Big Three.
    1. Give consumers data on how much unnecessary third-party billing costs the average primary care practice, both in dollars and non-patient care activities.
    2. They could also share and explain how PPO repricing is used to recapture large amounts of revenue for networks, while feeding the larger more expensive hospitals at an unfair disadvantage to the smaller surgical centers.
    3. If they really want to be transparent, they would explain why we have to lump even the most routine and affordable medical services into an expensive pre-paid health plan, where we must send these inexpensive and services through a complex and expensive billing cycle in order for doctors to get paid.
    4. Aetna, Humana and UHC could also explain how the artificially high CPT/EM codes justify exorbitant premiums and how these exorbitant premiums support these artificially inflated prices.
    5. Maybe they could be real transparent and explain to us ignorant folks why we need to insure inherently inexpensive services such as strep throat or a few stitches, when the true cost of delivering this level of care is way below what is billed out.
    6. While they’re at it, they could add up how many billions of dollars go to support industries and para-medical professions that exist only to support an unnecessary third-party payment billing cycle.

    Once they tackle those issues, then maybe we can have a serious discussion about “transparency”.

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