The Alliance of Community Health Plans (ACHP) issued the below statement in response to the Centers for Medicare & Medicaid Services’ (CMS) proposed hospital price transparency rules:
ACHP has long supported efforts to make health care pricing information more transparent, understandable and actionable for consumers. ACHP’s stance has been informed by its membership—nonprofit community health plans that are closely aligned with hospitals and physicians. ACHP acknowledges the Department of Health and Human Services’ ongoing efforts to promote cost and quality information in ways that are meaningful to everyday Americans who often struggle to navigate the complexities—and high costs—associated with medical care in the U.S. ACHP looks forward to supporting the Administration’s price transparency goals and providing meaningful and actionable comments on the proposed Medicare regulations released on July 29. It is imperative that consumers are equipped with a full range of comparative data on value, quality, safety, effectiveness, and price to make informed decisions about their care.
Many of our member companies already go far beyond what is required in an effort to provide their beneficiaries with real-time pricing information that is understandable and tailored to an individual’s personal circumstances, such as copays and deductibles. For instance, Grand Rapids, Michigan-based Priority Health has been offering pricing information through its Cost Estimator app since 2015, and has tallied more than $9 million in savings from members who choose a “fair market price” location for care. And Minneapolis, Minnesota-based HealthPartners’ drug pricing app, RxCost, allows members to price shop across multiple pharmacies to ensure they receive the lowest available prices.
These services, which are provided at no cost to the consumer, work and align with the goals spelled out by the Administration and Congress. But it’s also important to remember that these tools were developed in ways that are customized to the individual member—not a single data dump that leaves consumers doing the hard work of deciphering and translating the information. Our members would welcome the opportunity to demonstrate how their pricing tools work.
ACHP and its members support the goals, direction and intent of where the Administration is headed. We look forward to continuing to share the on-the-ground stories from our members in ways that will ably inform and support CMS’ goals on price transparency.
The Alliance of Community Health Plans (ACHP) is a national leadership organization bringing together innovative health plans and provider groups that are among America’s best at delivering affordable, high-quality coverage and care. ACHP’s member health plans provide coverage and care for more than 21 million Americans across 34 states and the District of Columbia. These organizations focus on improving the health of the communities they serve and are on the leading edge of innovations in affordability and quality of care, including primary care redesign, payment reform, accountable health care delivery and use of information technology. To learn more, go to www.achp.org and follow ACHP on Twitter @_ACHP.