Despite a growing demand from consumer and industry groups for greater transparency from health benefits providers, health plans continue to resist offering much beyond the most basic tools to evaluate pricing and related factors.
That's the latest from a benchmark study presented this week by HealthSparq at the America's Health Insurance Plans Institute 2013 in Portland.
The company, a health care transparency solution vendor, said most health plans aren't offering "essential health care cost and quality information to members." But to continue to resist will be futile, because pressure continues to mount for health plans to come clean on costs and benefits.
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"In the midst of health care reform, and change happening in the health care marketplace, costs continue to be unsustainable for employers and individuals," said HealthSparq President Scott Decker. "The marketplace is responding slowly as consumers demand more information to comparison shop for health care."
HealthSparq commissioned the Cicero Group, an independent market research firm, to perform the survey. What Cicero turned up was that "transparency is expected to emerge as a point of greater organizational focus, and interest in third-party tools to provide enhanced transparency for consumers is anticipated to grow."
The survey's results confirmed research that's been done by the employer coalition Catalyst for Payment Reform. The organization's executive director, Suzanna Delbanco, said that pressuring health plans to be more transparent about costs and choices is among CPR's top three objectives.
"Price transparency is very important building block to true health care reform," Delbanco said. "One of our goals is to make sure consumers have access to information about what their health care choices will cost them. They need this information to make an informed choice. Health plans are beginning to have some kind of cost calculator, but they are not very good generally and don't really help consumers make good choices."
Delbanco said many health care providers continue to refuse to allow health plans to share pricing information, further frustrating efforts to make the healthcare system more transparent.
"Payment needs to be tied to and sensitive to health care provider performance," she said. "Until health plans are willing to share true pricing information with their customers, uninformed and costly choices will continue to be made by consumers."
HealthSparq said that, despite resistance among many health plans to transparency tools, the niche market continues to grow. HealthSparq cited a recent study that predicted that the health care transparency industry will grow to $3 billion by 2016.
"More than two-thirds of health plan executives and managers agree it's important to equip members with the tools they need to make informed healthcare decisions," said Cicero Group CEO Randy Shumway. "However, with varying levels of awareness of availability of different transparency tools, there is clear room for increased understanding of the full scope of what transparency is and can entail."
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
