Three New Jersey health insurers, Aetna, UnitedHealthcare and Humana, are among the first to partner with Health Care Cost Institute to develop a free online medical care shopping tool that will allow consumers the ability to research the price and quality of health care services.
HCCI said it will create and administer this new information portal which it plans to launch in early 2015. Initially, only the three health insurers have come on board — but HCCI said other major carriers have expressed interest and predict more will either sign on in the near future, perhaps in time for the 2015 launch.
The health benefit companies will provide information on health care costs to HCCI, which will maintain and manage access to the information in a secure, protected environment.
The new transparency tool that HCCI is developing will aggregate pricing data from commercial health plans, as well as Medicare Advantage and Medicaid health plans, if the states agree.
Joel Cantor, director of the Rutgers Center for State Health Policy, said, "This is a wonderful resource. There are large variations among health care providers in charges to consumers. Even though a majority of New Jersey residents are not insured by the three participating carriers, the information can be useful to consumers."
The information will be available to consumers, purchasers, regulators and payers in an accessible, comparable and easy-to-use format. HCCI said the information it gathers will be useful for consumers, employers, payers, health care providers and regulators.
“The HCCI governing board is pleased by the trust the participating insurers are placing in the institute. The foresight and commitment of these insurers to create a national resource for consumers, employers and policy makers is without precedent,” said Stephen T. Parente, chair of HCCI’s governing board. “This new transparency initiative seeks to ensure that every American gets the best value out of their national investment.”
Most health insurers who operate in New Jersey already provide their members with online shopping tools, including Horizon Blue Cross Blue Shield of New Jersey, Cigna, Aetna and UnitedHealthcare. In addition, several independent websites provide this information to the general public, including Vitals, based in Lyndhurst.
HCCI said insurers will continue to offer their own shopping tools to their members, in addition to working with HCCI.
The New Jersey Health Care Quality Institute works closely with HCCI and its executive director David Newman, said Linda Schwimmer, vice president of NJHCQI.
"We think that HCCI can play an important role in making health care costs more transparent in New Jersey," she said
A major cost driver in New Jersey is the tendency for health plan members to seek higher cost care from providers outside their health plan network. Schwimmer said the HCCI shopping tool could help address the out-of-network issue.
"Whether HCCI could also be a resource for quality is to be determined. We would need to understand the methodology HCCI would use and HCCI would need to have a large enough segment of the population’s claims to be meaningful and accurate,” she said.
She noted that currently New Jersey's largest health insurer, Horizon Blue Cross Blue Shield of New Jersey, is not contributing its data to HCCI, "but if that were to change it opens up many possible uses for consumer transparency. As more of the cost and risk is placed on consumers, they need to have the tools to understand the cost and the quality of care they are choosing."
UnitedHealthcare spokeswoman Mary McElrath-Jones said the tool “will help improve access to cost and quality information for consumers and employers, helping to reduce costs and improve patient engagement.”
Aetna spokeswoman Susan G. Millerick said, “We believe that the health care system should be redesigned around the consumer and provide reliable, transparent cost and quality information to help consumers compare, shop and recognize that they have choices is a major part of that process. This initiative is a step in the right direction and will provide all consumers with access to comprehensive information about the price and quality of health care services.”
“Consumers, employers and regulatory agencies will now have a single source of consistent, transparent health care information based on the most reliable data available, including actual costs, which only insurers currently have,” said David Newman, executive director of HCCI. “Voluntarily making this information available will be of immeasurable value to consumers and other health system participants as they seek to manage the cost and quality of care.”
HCCI noted that health care costs have been rising more than three times as fast as wages and cited official estimates that U.S. health spending will reach $4.7 trillion by the end of the decade.
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