As an April 17 article in the Boston Business Journal noted, “A new report has found that though insurers are doing a better job providing cost estimates for their members, consumers still aren’t all that interested in shopping for their health care. The results come from a recent study conducted by the non-partisan research organization Pioneer Institute, intended to follow up on an analysis done in 2015 by consumer advocacy group Health Care For All,” the Boston Business Journal’s Jessica Bartlett reported.
As described on its website, the P:ioneer Institute is “an independent, non-partisan, privately funded research organization that seeks to improve the quality of life in Massachusetts through civic discourse and intellectually rigorous, data-driven public policy solutions based on free market principles, individual liberty and responsibility, and the ideal of effective, limited and accountable government.”
As Bartlett noted in her article, “The online tools were developed as the result of a state law passed in 2012, which required insures to develop cost estimator tools by October 2014.” She quoted Barbara Anthony, the primary author of the report and the former Undersecretary for Consumer Affairs and Business Regulation, as stating that “We’re beginning to move in the right direction.”
As Bartlett reported, “Health Care For All assessed the tools the following year, and gave the state’s three largest insurers—Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim Health Care and Tufts Health Plan—a ‘C’ grade for their cumbersome and ineffective systems. Since then, Blue Cross has made several improvements to its tool, changing the name to “Find a Doc and Estimate Costs,” making it more prominent on the website and clearly showing out-of-pocket costs and remaining deductibles. Harvard Pilgrim and Tufts also had to completely remake their websites after their vendor for the service pulled out of the market. The new cost estimator sites now explain out-of-pocket consumer costs, remaining deductibles and even quality metrics.”
Still, Bartlett noted in her article, “Despite there being better tools, there were only 297,000 inquiries on the cost estimator tools from early 2014 through 2017. Combined, the three insurers cover three million people.”
Anthony told Bartlett that "Health care price transparency is still a new idea to many consumers and to providers. It’s almost an alien concept—the idea people should know how much their healthcare will cost before they incur the procedure and may opt for lower cost providers…so (we need to be) educating consumers, educating employers, providing information in an easy to understand way, providing incentives for people in an easy way,” Anthony said.
And, Bartlett wrote, “While the prevalence of high deductible health plans may spur some people to shop for their care and use price estimator tools, Anthony said there needs to be a growing focus on incentive programs that encourage consumers to shop for health care. Currently,” she said, “only large employers with over 250 employees offer much in incentive and reward programs for choosing a lower-cost health care provider — a feat that would require using the online tools. Anthony said carriers are offering such programs to compete with national carriers that have those tools. But not much is being offered to employers with under 50 employees.”
As reported on the Pioneer Institute’s website, Massachusetts health plan executives responded to the findings of the report.
Harvard Pilgrim president and CEO Eric Schultz said that, “In a rapidly changing healthcare environment, providing consumers with transparency around cost and quality information is important and will help them make informed healthcare choices. We at Harvard Pilgrim have long been committed to promoting the value of transparency, and we are pleased to see that Pioneer Institute continues to keep a public focus on the issue. We were happy to work with them on this report.”
Meanwhile, Andrew Dreyfus, president and CEO of Blue Cross Blue Shield of Massachusetts, said, “Blue Cross is pleased that the Pioneer report acknowledges our ongoing commitment to providing our members with state-of-the-art tools to make informed decisions about the cost and quality of their healthcare. Members who understand their benefits – those who aren’t surprised by bills and feel empowered – are much more likely to be satisfied members and engaged patients. I thank Pioneer Institute for their continued focus on this issue.”
And Tom Croswell, president and CEO at Tufts Health Plan, noted that “Transparency is essential among all stakeholders in healthcare to ensure that customers and employer groups can make informed healthcare decisions. Our new, easy-to-use tool enables members to not only find high-quality, high-value providers in their area, but also see their potential costs from the beginning to the end of a procedure. The new tool is simpler and far surpasses the capabilities of the first generation of transparency tools. We applaud Pioneer Institute’s work on keeping this important issue at the forefront.”
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