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Insights

May 19, 2014

Three of the Largest Payers Will Give Consumers Free Access to Healthcare Prices Beginning in 2015

Published

May 19, 2014

On May 14, the Health Care Cost Institute (HCCI) announced that it will work with Aetna, Humana and, UnitedHealthcare to provide consumers free access to an online tool that displays information about the price and quality of healthcare services beginning in 2015.

The tool will aggregate pricing data from commercial health plans, as well as Medicare Advantage and Medicaid health plans, if states agree. Participating insurers will provide cost information to HCCI, who will manage access to the information, and will be supplemented with quality and other information.  Participating insurers will continue to offer their own cost transparency tools and solutions as well.  

HCCI’s tool will provide: Beyond this information, HCCI has disclosed little detail on the type of pricing and quality information that will be posted or how the data will be aggregated, making it difficult to predict the tool’s impact on the decisions of each of these stakeholder groups.

  1. Consumers with a transparent and comprehensive portal to make more informed decisions.
  2. Providers with a means to view quality and cost information about other providers.
  3. Payers with the means to maintain proprietary data while allowing access to important information for consumers.
  4. Regulators with a single source of information to support market studies to help inform geographic rate adjustments and provide guidance on important public policy issues.  

This announcement is not the first example of efforts to increase the transparency of healthcare cost and quality.  In 2013, Medicare opened up hospital charge databases to the public, and last month unveiled a database of Medicare payments to doctors.  Additionally, many states have implemented laws or regulations that require providers and payers to share payment information, although a recent report suggested that many states are failing in this effort.  This trend is in part a response to growing pressures on health insurers to justify increased premiums and the belief that empowering consumers with this information will push patients to shop for higher value care and will ultimately help payers keep costs down.

As consumers face higher deductibles and larger copayments, they may be more motivated than they have been in the past to use tools like HCCI’s to inform their healthcare decisions.  More visibility of the price and quality of healthcare services will in turn reinforce existing pressures on providers to deliver high quality care more efficiently and on manufacturers to substantiate the value of their products.  

HCCI expects to launch the tool in early 2015.  More details are likely to come out on the tool as we get closer to the launch date. After the tool’s launch, HCCI will continue to refine it to include more comparison features and, in the longer term, include data from fee-for-service Medicare and Medicaid programs.

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