Principles help consumers obtain healthcare price info

A task force made up of healthcare leaders and consumer representatives has reached consensus on how consumers can obtain clear and easy-to-understand information about their financial obligation for healthcare services, before any tests or procedures are performed.

Led by the Healthcare Financial Management Association (HFMA), the task force developed guiding principles and recommendations for price transparency that highlight how hospitals, physicians, and health plans would share reliable information on healthcare prices with consumers. Combined with other relevant information, such as quality and safety, price information will help consumers make more informed healthcare decisions.

"People everywhere want to be smart healthcare consumers, but information about healthcare prices is not easily accessible," said Joseph J. Fifer, FHFMA, CPA, president and CEO of HFMA. "For too long it has been unclear how consumers should go about getting price information — who to ask, what to ask for, or what the information even means when they do receive it. This approach is a game changer."

The task force included representatives from America’s Health Insurance Plans, the American Hospital Association, Catalyst for Payment Reform, Community Health Advisors, and others, including a patient. Working together, stakeholders identified how anyone can receive reliable price information, tailored to insurance status. Participants agreed that patients who are insured should rely on their health plans to provide price information. The task force also agreed that hospitals should serve as the primary price information resource for uninsured patients and those seeking care outside of their insurance network.

Stakeholders agreed that consumers should be able to make meaningful comparisons before common elective services with usable price estimates and quality information, enabling consumers to understand the value of the care they will receive. The task force also called on health plans and providers to make price information available in easy-to-understand formats so that consumers can make the most of the information at their disposal.

Task force participants called the release of the guiding principles and recommendations a critical step toward greater transparency of price information.

"It’s entirely reasonable for consumers to expect better access to price information," said Fifer. "We are calling on all healthcare stakeholders to acknowledge that and to deliver the clear, reliable price information consumers are looking for. By achieving consensus about the roles all stakeholders should play, we have taken a giant step in the right direction."

To see highlights of the guidelines, go to http://bit.ly/1rq5ErV.