Transparency Comes to Health Insurer Payments

When the calendar turned to July, health insurers came under a new federal requirement that they post on web sites the price they pay to every provider with which they contract for every service they cover.

The mandate, which traces its origins to the Affordable Care Act and was introduced in a 2019 executive order, was designed to enable consumers to compare what different insurers pay different providers for different services and possibly help them shop for more affordable services for themselves.  Doing so, however, will be a challenge for consumers at least at first because insurers will be posting millions of figures.  Eventually, though, businesses are expected to emerge offering to help consumers with their price comparisons.

Insurers that fail to post the required data will be subject to fines far greater than those suffered by hospitals that do not post their charges as required.  In addition, beginning next year insurers will be required to post 500 “shoppable” services – that is, bundles of service associated with some of the most common medical procedures.

Learn more about health insurer price transparency and the implications for insurers, providers, and consumers in the Fierce Healthcare article “How much health insurers pay for almost everything is about to go public.”

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