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Task Force Report Highlights Price Transparency in Health Care

Group says hospitals should serve as price information resource for uninsured people

Convened by the Healthcare Financial Management Association (HFMA), a task force made up of health plans, providers, consumers, employer groups, physician groups, and others has released recommendations for improving price transparency in health care.

The task force agreed that all Americans, regardless of their insurance status, should be able to receive accurate price estimates from a reliable source; that transparency should help people make meaningful price comparisons ahead of service; and that price estimates should be accompanied by other relevant information (e.g., quality, safety, or outcomes) that will help consumers assess the value of a health care service.

According to the report, health plans are in the best position to help their members find out the total estimated price of a service. The task force suggests that plans should help members estimate their expected out-of-pocket costs, based on their current deductible status along with copayment and coinsurance information. Health plans often have access to price information for many providers in a given region, which they can use to help members factor price into their decision-making process.

In addition, hospitals should serve as a price information resource for uninsured people, the report says. Key recommendations include the following:

  • Hospitals should continue to help uninsured patients identify alternatives for sharing their health care costs, including insurance options of which they may not be aware.
  • Hospitals should proactively communicate to all patients and community members — including the uninsured — that they may be eligible for financial assistance provided directly by the hospital. This financial assistance could mean that care is available for free or at a discount.
  • Taking insurance eligibility and financial assistance into account, hospitals should offer uninsured people clear information on how to receive price estimates.
  • All parties that provide price information should make clear to patients which services are and are not included in their estimates, and should offer other relevant information, such as quality and safety data, where available.

The report also states that consumers should receive price information in an easy-to-understand format so that they can make the most of the price information resources at their disposal. The HFMA has developed a guide to help consumers get answers to their questions about health care prices.

Finally, the task force feels that employers can play a role in price transparency by encouraging their employees to be engaged in their health care decisions.

Source: HFMA; April 22, 2014.

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