What to Know About Price Transparency in Health Care
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Over the next few years, there will be more transparency when it comes to health care, according to Experian.
The federal government has provided the healthcare industry with a phased-in approach to the transparency of certain medical costs, which started in January 2021, and its transparency is expected to be fully realized by January 2024.
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There are many reasons why the federal government has mandated this change, two of them being that it was discovered in a Kaiser Family Foundation survey, one-in-three families had a surprise medical bill in the past two years.
The second is that it is hoped that publicizing the pricing of certain medical treatments will generate competition in the healthcare industry to become competitive for the consumers’ dollar.
In January of 2021, hospitals began to advertise the rates they have negotiated with insurers online and with a consumer-friendly list of about 300 services.
In 2022, insurance companies must provide information that reflects their in-network negotiated provider rates, out-of-network coverage rates, and in-network drug pricing.
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In January of 2023, health insurance companies must develop an online shopping tool for consumers that will include information on out-of-pocket cost estimates and negotiated prices for 500 of the most shoppable items and services, of which 70 specific services are mandated by the government.
By January 2024 the remaining procedures, drugs, medical equipment, and other items or services will need to be available on the online shopping tool for consumers.
Having the ability to comparative shop for certain common medical procedures, as well as drugs and equipment, it is hoped that the consumer will be more informed of what the procedure will cost them out of pocket as well as prepare them more for the financial impact it may have on them.
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