Comparison shopping is good consumerism. At least that’s what I was taught growing up.
Imagine my surprise as an adult when I encountered my first major medical event — thankfully it was a joyful one, the birth of my first child — and suddenly my bargain-hunting skills were rendered almost useless.
As it turns out, consuming health care was not like consuming other commodities. I couldn’t shop around because my insurance plan covered one hospital system in my area. I couldn’t leverage a lower price with a competitor. And without a clear understanding of the pricing structure, I couldn’t even determine if I was getting the best available “deal.”
But that may be changing. In 2020, the federal government finalized the Transparency in Coverage Rule, and as of July 1, 2022, health insurers and group health plans are now required to disclose pricing information to consumers.
The idea is to give health care consumers unprecedented insight into the cost of a covered item or service before receiving care. It should also demystify out-of-pocket costs by revealing more accurately what insurers will actually reimburse.
In a timely conversation with Network Health President and CEO Coreen Dicus-Johnson for our insurance industry report on page 38, she asserted that pricing clarity in health care coverage is actually a component of informed consent — making the best medical decisions with a full understanding of the benefits and risks.
She clarified the rule requires not only that pricing data be public, but that it’s posted “in a consumer-friendly way, which means you don’t have to have a Ph.D. in health care analytics to understand them. Part of informed consent is understanding what it means to you financially and medically,” Dicus-Johnson says.
While it may be a while until we reach true transparency in coverage, the bargain hunter in me is optimistic. I’ve been reading about tech companies working with health care organizations and insurers to create consumer-friendly platforms where pricing data, a doctor’s specialty and location are all searchable. The user experience of these platforms has been likened to booking an Airbnb, except instead of reserving a villa in Tuscany you’re reserving a colonoscopy.
While the former is certainly more appealing, the latter is extremely important — and being able to comparison shop both should be, at least somewhat, exciting for consumers.
