Large Employers Demand Transparency in Healthcare Pricing, Quality

Consumers should be able to shop and compare for healthcare online, a consortium of large employers recently demanded in a statement released yesterday.

The Catalyst for Payment Reform, an association funded by large US employers such as Wal-Mart, Intel, Boeing, Disney, and GE, has called for healthcare insurers and providers to publish pricing and quality data so that third-party organizations can create tools to enable consumers (and, presumably, insurance purchasers) to compare prices and quality of competing healthcare systems.

In a public announcement — “Statement by CPR Purchasers on Price and Quality Transparency in Health Care” — the organization makes four demands of healthcare providers and insurers:

• Consumers must have access to meaningful, comprehensive information about the price and quality of services to make informed health care decisions.
• Providers and health plans must make such information available.
• Self-insured purchasers have the right to use their claims data to develop benefit designs and tools that meet their needs.
• Current anti-trust laws should be adhered to and enforced to ensure that providers and health plans do not use price information in an anti-competitive manner.

CPR is calling for these reforms to be effective by January 2014.

Some insurers, such as UnitedHealth Group, have developed transparency tools for their customers, but they are solely based on their own pricing and quality data. CPR wants insurers and providers to make that data more widely available.

The organization recognizes that such information is competitive, and that making it widely more available carries the risk of raising prices. While publishing such information could compel those providers and insurers with high prices to lower their prices, it is also equally possible that those providers and insurers with lower-than-average pricing would increase their prices. “To address this, appropriate parties must monitor such transparency with suitable oversight mechanisms,” according to CPR’s statement.