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Study of Private Insurance Funds in Australia Finds Online Out-of-Pocket Cost Tools Difficult to Interpret

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Out-of-pocket costs are highly variable and patient ‘bill shock’ is an increasing concern in Australia. Private insurance funds have created online tools to share procedure cost estimates based on their claims data.

A study published in Australian Health Review is the first review of Australian insurance funds’ price transparency tools, comparing and contrasting the information three Australian private health insurance funds (HCF, Bupa and Medibank) have provided on their online out-of-pocket cost tools and to consider the implications this has for price transparency in Australia.

The study found cost information difficult to interpret both within funds (for members) and across funds (for the system). Policy makers will need to consider the complexities and presentation options for cost estimates within the health system if they move ahead with a public price transparency tool. There is still a requirement for cost information that can facilitate price shopping across providers and funders.

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