A new frame­work for price trans­parency

Modern Healthcare - - BEST PRACTICES -

For in­sured pa­tients: Health plans should take the lead in pro­vid­ing price and qual­ity in­for­ma­tion to their mem­bers, in­clud­ing to­tal es­ti­mated price, es­ti­mated out-of-pocket costs, which providers are in net­work and qual­ity data.

For unin­sured and out-of-net­work pa­tients: Hos­pi­tals and other providers should be the main source of in­for­ma­tion. They should clearly state what ser­vices are and are not cov­ered in a pre-ser­vice es­ti­mate.

For em­ploy­ees in a com­pany health plan: Em­ploy­ers should pro­vide trans­parency tools that of­fer cost and qual­ity in­for­ma­tion to guide their work­ers to high-value providers.

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