Monday, December 11, 2006
MEDICAL SERVICE PRICES, PROVIDER PAYMENTS COULD CHANGE AS HEALTH INSURERS INCREASINGLY MAKE COST DATA PUBLIC
Kaiser Daily Health Policy Report -Dec. 4: Health insurers are beginning to reveal the costs of health care services, a move that might "ultimately change what providers charge and how much consumers pay," the Miami Herald reports. Charges for services can vary by as much as 30% depending on the provider, according to Cigna. Cigna spokesperson Joe Mondy said providing price information to consumers "helps provide clarity on how much things cost." In January 2007, Cigna in 58 markets will begin to offer the Cigna Care Network, which will include doctors who score well on quality and cost-efficiency measures. The trend has sparked concern among some physicians about the definitions of efficiency standards. The American Medical Association in November passed a resolution seeking laws that would prohibit insurers from creating networks "based solely on economic criteria."Nancy Nielsen, head of AMA's House of Delegates, said, "You have to look very carefully at those efficiency numbers. Some are only about costs. That's where it gets tricky. That's where the biggest fights and negotiations are."Insurers contend their efficiency measures will not be based solely on costs but add that actions need to be taken to address the cost disparities in health care. Charles Cutler, national medical director for Aetna, said, "The more people understand the cost of health care, the better off we will be."Brian Klepper of the Center for Practical Health Reform said, "We're at the leading edge of a huge change" (Dorschner, Miami Herald, 12/3).Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. ©2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
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