SIOUX FALLS, S.D. (KELO) — When choosing a health care provider, American consumers have so far had only reviews of the quality of care to rely on with little information about how much that care might cost.
But in tonight’s Your Money Matters, how a new transparency rule is one step closer to giving consumers the information they need to shop around.
“It is frustrating that you do not know how much it costs when you enter,” Cheryl Berkland said.
Berkland, like many Americans, has been surprised by unexpectedly high healthcare bills several times in her life.
That health bill sticker shock is the focus of the new ‘No Surprises Act‘ that took effect in January, working to help prevent surprise emergency healthcare bills across the country. Now another new multi-phased federal law is taking effect to help make health care pricing more transparent.
“To enable consumers on shopping the marketplace so they can get the best value for their dollar,” Sanford Health Plans Principal Strategic & Operations Advisor Stephanie Wessels said.
Like all insurance companies, Sanford Health Plans is working to enact the changes laid out in the new federal laws on health care pricing transparency.
“We’re required to release large information in files that shows consumers and third-party application advisors what we pay for in-network and out-of-network rates,” Wessels said.
Those large data files were released by all health care insurance providers on July 1st; its the first time the cost of care has been made public, even though the files are too complex for consumers to gain any real insight. But Wessels says that data will now be used to create a new online tool for consumers to check prices on different health care services at different providers.
“Consumers can ask to get the codes from provider, then they come to our web-based tool,” Wessells says.
“It might then say you’ll pay $1,000 based on your plan, where you’re at with your deductible, your co-pays, etc. So consumers will know exactly what they have to pay when they walk in to get services.”
A new concept in healthcare many consumers are celebrating.
“Then you know how much money to budget,” Berkland said.
It’s a tool consumers will be able to access online by this January for the top 500 health services and by January of 2024, consumers will be able to compare prices for all procedures at any provider across the country.
“It’s nice to know what your costs are before you do it,” Berkland said. “Then you’ll know the cost of it and won’t get a surprise and have to come up with more money.”
Along with giving consumers a better idea of how to budget for health care expenses, the other goal of this new federal transparency law is to help bring health care prices down as providers work to provide competitive pricing.