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In theory, price transparency encourages consumers to choose lower-cost options for shoppable health care services. (Photo: Shutterstock)

An ongoing dual crisis in the U.S.—the COVID-19 pandemic and its accompanying economic contraction—has put even greater pressure on benefits advisors and their employer clients to rein in health care costs and ensure employees are good stewards of their benefit dollars.

The pandemic has also brought into public focus the potential for unfair health care pricing. The CARES Act, passed by Congress in March, requires all private health insurers to reimburse providers for COVID-19 tests based on the in-network rate in place prior to the pandemic. If the provider is out of network, health plans pay the provider’s “cash price” (or a lower price, if the plan can negotiate one). As long as the public health emergency continues, this price must be publicly available. The requirement to publish the price of the test is intended to keep prices reasonable.

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