Your Health Matters


Transparency in health care costs rules due to launch July 1st

Posted at 9:56 AM, Jun 23, 2022
and last updated 2022-06-23 12:56:41-04

(KERO) — More transparency around health care costs is supposed to be coming soon with new rules going into effect July 1st.

The new rules require health insurers to make their pricing information available for all "covered-in-network" services and procedures.

"In theory, if you have if you're insured by a private health insurance plan you can go online, you can log in to this portal, and you can look at all the different procedures, lab tests, surgeries, everything that's available in the world and learn what it's going to cost you out of pocket at various providers in your area and across the country," explained Kevin Brasler, the executive editor at Consumers' Checkbook.

But there are concerns about compliance based on what has happened with hospitals. They've been required to publish prices since January 2021 but a recent study in the Journal of the American Medical Association" looked at 5,000 hospitals nationwide and it found fewer than 6 percent were fully compliant with the rule.

Consumers' Checkbook recently looked into some of the hospital price tools that are currently available. It found many are "clunky, glitchy or not very helpful."

"Really no set parameters for how consumer-friendly those tools have to be and what we saw from the hospitals, is that a few at least tried to build consumer-friendly patient-friendly tools, but many didn't," says Brasler. "And that's the worry I have is that some health insurance plans just - they build stuff according to the rules, but they, you know, they just get in under the minimum right."

Consumers' Checkbook found some health insurers have already released price disclosure tools ahead of the July 1st requirement. It says the information they're providing can be useful to help patients shop around to save on their care.

The new laws around healthcare pricing transparency are also leading to new websites that claim to do the cost comparisons for you. Consumers' Checkbook" signed up for a few of these to compare.

For one the results, it gave only showed the average out-of-network fees paid by those without insurance. Another site only reported what insurance companies pay and didn't include the lower out-of-pocket costs.