First in Light

Submitted by on Friday, January 16, 2015 - 02:57

Newtown, CT – January 16, 2015

And then there was light – In one fell swoop, Blue Cross and Blue Shield of North Carolina has disproven all those who have falsely claimed that pricing information is proprietary and constitutes a significant competitive advantage. From New York to Florida, New Mexico to Washington, and in between, state legislators are busy trying to pass some legislation that would authorize the collection of payer claims data for the purpose of releasing health care pricing information to the public. Commercial insurers and some providers are fighting hard to keep consumers in the dark with spurious arguments. And in this fight, the State of North Carolina has shown the way. Last year it adopted some modest transparency measures that released charge information on common procedures. It wasn't great, but it sent a pretty strong signal. Blue Cross and Blue Shield has responded and upped the ante. Their website bares it all and they should be greatly commended for taking such a significant step. They show, by product line, the full episode cost of procedures and enable a plan member (or anyone else) to compare the prices by provider.

What this means to you – A recent report from the Universal Health Care Foundation in Connecticut shows what happens when price and quality information is shielded from the public. Consolidations continue to pervade the market, prices go up and quality is, by most measures, terrible. While there is legislation in that state to enable an all-payer claims database, there has been little progress to assemble the data, let alone release valuable information on price and quality. In our national scorecard on price transparency released last year, we made it a point to emphasize that it isn't sufficient to pass legislation. What's needed is to act on that legislation in order to push the market towards the light. Of course, that often isn't enough either because you also need the courage of plan CEOs such as Brad Wilson to finally say: Enough! Let's end this charade and get on with it. For all state legislators busy at work in their new sessions, look at this example, and when the next plan apparatchik shows up to mouth off idiotic statements about the proprietary nature of pricing information, point them to the State that was "First in Flight" and now, "First in Light".