A Pioneer Institute study finds some significant improvements in the online cost estimator tools created by Massachusetts’ three largest health insurers, but there is much still to be done for the carriers to maximize the opportunity price transparency represents. Online cost estimator tools give consumers/plan members online information about a range of information for outpatient and many inpatient procedures. These tools display the amount that has to be paid by consumers to any particular provider, how much the plan pays the provider, and information about provider quality. Consumers can compare several providers at the same time. A 2012 state law required health insurers to develop online cost estimator tools by October 2014. In 2015, the advocacy group Health Care for All (HCFA) assessed the tools developed by Blue Cross Blue Shield (BCBS), Harvard Pilgrim Health Care (HPHC), and Tufts Health Plan, which together controlled nearly four-fifths of the state health insurance market. HCFA gave each a grade of “C.” The same law also requires hospitals and doctors to provide consumers with prices of services upon request. Previous Pioneer studies showed very poor compliance by Massachusetts providers with the Commonwealth’s transparency law.
- White paper: MA Health Insurers Have Improved Their Consumer Price Transparency Efforts, But Significant Work Remains. Pioneer Institute. April 2018 (PDF)