Massachusetts insurers boost price transparency with cost estimator tools

Massachusetts insurers continue to make progress with their cost estimator tools and price transparency efforts, but there is still a lot more they can accomplish, according to a Pioneer Institute study.

The study, conducted at the end of 2017, follows up on a 2015 evaluation by Boston-based advocacy group Health Care For All. As part of the initial evaluation, HCFA looked at Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim Health Care and Tufts Health Plan's compliance with state price transparency rules.

Massachusetts law required insurers to develop online cost estimator tools by October 2014, and HCFA assessed the effectiveness and efficiency of the insurer's tools in its 2015 evaluation. Harvard Pilgrim and Tufts got a C, and Blue Cross got a C-. 

In the 2017 study, Pioneer Institute assessed the same insurers and found "significant improvements" with the insurer's cost estimator tools.

"Simple changes such as those made by BCBS to the title and location of its tool can go a long way toward encouraging more frequent consumer use," the Pioneer Institute wrote. "Similarly, the extended scope of available procedures among all three carriers is very commendable. In general, the cost data presented on their tools is informative and easy for consumers to follow and understand."

Pioneer Institute said the insurers are also using incentive/reward programs to attract workers at entities with at least 250 employees to lower-cost, high-value providers.

"The ability of consumers to compare several providers at once and to obtain results in a variety of ways such as low to high dollar values or distance from home or work is very helpful," the Pioneer Institute wrote. "Each carrier also has a drug price tool for members, and access to these separate tools is relatively straightforward."

Even with these and other improvements, the 2017 study notes there are still various deficiencies with the tools — HPHC does not include information on behavioral health procedures in its online tool, and none of the carriers offer their sites in languages other than English.

Pioneer Institute said nearly 300,000 aggregate inquiries over the course of about three years is a "positive start" as far as consumers using the insurer's online tools. However, the study's authors wrote, "compared to the potential market of over three million members, it shows there is a lot more that can be accomplished."

Access the full study here.


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