Major health plans agree to open up pricing data to consumers

Three of the nation’s largest health insurance companies--Aetna, Humana and UnitedHealthcare--will work with the Health Care Cost Institute (HCCI) to develop and provide consumers free access to an online tool that will offer comprehensive information about the price and quality of healthcare services.

The independent, not for profit HCCI will create and administer this information portal, which is expected to be available in early 2015, according to a release. The health benefit companies will provide information on healthcare costs to HCCI, which will maintain and manage access to the information in a highly secure, protected environment. Other major carriers have expressed interest and HCCI expects additional carriers to participate in the near future and be part of the initial release in early 2015.

Participating insurers will continue to offer their own cost transparency tools and solutions as well. The cost data will be supplemented with quality and other information to provide consumers a transparent and comprehensive destination to make more informed decisions about healthcare.

“You have to give up control to get power,” said Mark Bertolini, chairman, CEO and president of Aetna, speaking at the National Healthcare Innovation Summit on May 14 in Boston. “Why should we care what our fee schedules say? They’re all pretty close anyway.” The people who really need to know prices are those paying out of pocket, he added. “To create a retail marketplace, we need to give them the information.

With people paying almost 45 percent of their healthcare costs either through premiums or out-of-pocket expenses, “individuals are making tough decisions about what they pay for.”

Aetna, Bertolini said, is in the process of creating a retail arm and consumer marketplace. “Our transparency initiative is the first step to doing that.”

“Consumers, employers and regulatory agencies will now have a single source of consistent, transparent healthcare information based on the most reliable data available, including actual costs, which only insurers currently have,” said David Newman, HCCI executive director. “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.”

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. The information will be available to consumers, purchasers, regulators and payers in an accessible, comparable and easy-to-use format.

HCCI expects the transparency platform will continue to be refined in subsequent releases after its introduction. For example, future updates of the tool are expected to include more comparison features and, in the longer term, data from fee-for-service Medicare and Medicaid programs, as and when it becomes available.