PPI Releases Latest Report Rethinking Transparency in Health Insurance – InsuranceNewsNet


Targeted News Service (Press Releases)

WASHINGTON, June 30 (TNSres) — The Progressive Policy Institute issued the next news release:

The Progressive Policy Institute (PPI) released a recent paper today arguing United States policymakers should consider more aggressive ways to acquire health care pricing information from hospitals, which could effectively boost price transparency for patients. The paper is titled, “Rethinking medical health insurance: Can price transparency and money pay help consumers?” and is authored by Arielle Kane, Director of Health Look after the Progressive Policy Institute.

“For price transparency rules to work, they must be enforced,” writes report writer Arielle Kane. “When people have a serious accident or medical emergency, they are not inclined to comparison price shop. But most medical visits are for lower than urgent care. When people do have time and inclination to check prices, they need to have the ability to achieve this. And allowing researchers and journalists to review pricing data will help expose the predatory billing practices that some providers engage in. Public scrutiny could help the industry move toward ethical, and transparent, billing practices.”

Only 14% of hospitals are in compliance with a 2021 rule from U.S. Center for Medicare and Medicaid Services (CMS) requiring hospitals post the costs for 300 so-called “shoppable” services, online. This rule, which was intended to encourage competition between hospitals and supply price transparency for consumers, has limited enforcement mechanisms. As the following chapter of this rule goes into effect this week, requiring insurers to reveal the rates they pay hospitals, there’s the potential to enhance the shopping experience for consumers – but only whether it is enforced.

Kane’s report reviews the history and standing of the value transparency regulation and finds that greater enforcement is required to attain the complete potential of price transparency. After reviewing cash-pay data from 14 of the 300 “shoppable” billing codes, PPI finds that on average, hospitals charge 120% of the industrial insurance rates to patients paying with money. Nevertheless, there’s evidence to suggest that hospitals are inflating their publicly reported “cash-pay” rates.

Read and download the complete report here: https://www.progressivepolicy.org/publication/rethinking-health-insurance-can-price-transparency-and-cash-pay-help-consumers/

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Original text here: https://www.progressivepolicy.org/pressrelease/ppi-releases-new-report-rethinking-transparency-in-health-insurance/


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