October 29, 2020
The Alliance of Community Health Plans (ACHP) is disappointed that the Trump Administration released a finalized Transparency in Coverage rule, which requires health plans to make public competitively negotiated rates that could lead to higher prices—not lower. ACHP shares the goal of informed, empowered consumers but supports an approach that capitalizes on private-sector competitiveness and not burdensome mandates.
Health plans understand that consumers want clear, concise and easily digestible information about what they can expect to pay when seeking care. Moreover, they want this information delivered in familiar ways that reflect typical online shopping experiences. ACHP members also understand that arming consumers with accurate, detailed cost and quality information makes them better stewards of their own health.
Fortunately, many health plans, already offer easy-to-use pricing tools that allow consumers to get accurate cost estimates—either online, over the phone or in-person—for any number of medical services or procedures. Some of the most dynamic tools allow for comparisons across different provider types, geographic regions and factor in the quality of care being provided. Patients are using these tools today, reporting high satisfaction and significant savings. The mandates in today’s rule will only negate market successes already on track to deliver on the Administration’s laudable goals.
ACHP is concerned that the final rule ignores the innovation already occurring in the market and rather than building on these innovative price transparency efforts, it burdens patients and families with a data dump of complex – and in some cases irrelevant – information.
ACHP supports a personalized approach to transparency that avoids government mandates and enables consumers to access at their convenience accurate, timely, relevant information. We hope that Administration will see the progress already being made and reconsider these burdensome and unnecessary regulatory requirements.
With on-the-ground evidence and input from more than a dozen consumer and medical groups, ACHP has developed a price transparency certification framework that unleashes and builds-upon the creativity of the private sector to offer true price and quality information. Under the ACHP transparency initiative, health plans would voluntarily participate in an independent certification program, bestowing a “good housekeeping” seal of approval on transparency tools that meet or exceed a collection of meaningful performance measures.
Health plans and insurers have a direct stake in providing their members with tools that allow them to make informed, cost-and-quality conscious decisions. CMS should rely on the private sector’s connection with consumers rather than take a bureaucratic approach that misses the mark.
The Alliance of Community Health Plans (ACHP) represents the nation’s top-performing non-profit health plans to improve affordability and outcomes in the health care system. ACHP member companies are provider-aligned health organizations that provide high-quality coverage and care to tens of millions of Americans. They are leading the industry in practical, proven reforms around primary care delivery, value-based payment and data-driven systems improvement.
ACHP advocates on behalf of its members and a unique approach to health care today, one that puts the patient at the center with health plans and clinical teams collaborating to improve health outcomes and reduce costs. Our advocacy focuses on providing policymakers with tested solutions being realized in communities nationwide and rooted in a model that is proven to deliver better value for patients, employers and taxpayers. Learn more at the ACHP website and follow us on Twitter for the latest health insights.