New law makes health care pricing more transparent


SIOUX FALLS, SD (KELO) — When choosing a health care provider, U.S. consumers have so far had only opinions about the quality of care to rely on with little information about the cost of this care.

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.

“It’s frustrating not knowing how much it costs when you walk in,” said Cheryl Berkland.

Berkland, like many Americans, has been surprised several times in her life by surprisingly high health care bills.

This health bill sticker shock is at the center of the new “no surprises law” that took effect in January, aimed at helping prevent surprise emergency health care bills across the country. Now another new phased federal law is taking effect to help make health care pricing more transparent.

“To empower consumers to buy in the marketplace so they can get the best value for money,” said Stephanie Wessels, senior strategy and operations adviser at Sanford Health Plans.

Like all insurance companies, Sanford Health Plans is working to enact expected changes in new federal health care pricing transparency laws.

“We are required to release extensive information in files that show consumers and third-party app advisors what we pay for in-network and out-of-network rates,” Wessels said.

These big data files were released by all Medicare providers on July 1; this is the first time that the cost of care has been made public, even if the records are too complex for consumers to really have an idea. But Wessels says the data will now be used to create a new online tool for consumers to check the prices of different health care services from different providers.

“Consumers can request to get the codes from the provider and then they go to our web tool,” says Wessells.

“He might then say you’ll pay $1,000 depending on your plan, where you’re at with your deductible, your co-pay, etc. That way consumers will know exactly what they have to pay when they show up for obtain service.”

A new concept in health that many consumers are celebrating.

“So you know how much money to budget,” Berkland said.

It’s a tool that consumers will be able to access online by January for the top 500 health services and by January 2024 consumers will be able to compare prices for all procedures at any provider across the country. .

“It’s good to know what your costs are before you do it,” Berkland said. “Then you’ll know the cost and you won’t have any surprises and you won’t have to come up with more money.”

In addition to giving consumers a better idea of ​​how to budget for health care spending, the other goal of this new federal transparency law is to help lower health care prices as providers strive to offer competitive prices.


About Author

Comments are closed.