Friday, March 30, 2007

Full Disclosure...

No, not mine, but the health care and health insurance industries'. Part of the transparency efforts we champion so often here at IB has to do with pricing: how much does this procedure cost? What's the price of that MRI? Is the generic really the best deal?
One problem consumers have is that there's a basic disconnect in how much they are charged for a given service as opposed to how much the insurance company allows, and how much they actually pay. Anyone who's seen an EOB (Explanation of Benefits) form knows that what the provider initially charge has little to do with how much they ultimately collect (from the insured and the carrier).
We've talked about various insurers' programs before: Aetna's initial pilot program in Cincinnati, Blue Cross of Minnesota's HealthCare Facts efforts come immediately to mind. A new survey by PNC Financial Services Group found that there is widespread support for such information:
They surveyed 1,000 consumers, as well as 150 hospital executives and 50 health insurance company executives. Granted, this isn't a huge sample, but it certainly indicates a growing trend that both industries are going to have to address, apparently sooner rather than later.
On the one hand, there's been precious little evidence that consumers are clamoring for this in great numbers: we seem to be more interested in our own out-of-pocket than the total cost of services received. Still, well over half of the consumers in that survey indicated that knowing how much a given procedure or treatment would cost would affect their ultimate buying decision.
And it is a buying decision: we purchase health care, not simply receive it.
And hear this, Medicare administrators and health insurance exec's: almost 8 in 10 of those consumers would like to see a break-out of how much of each bill goes to administrative costs as opposed to clinical care.
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