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Groups urge pricing transparency in healthcare


By Jessica Zigmond
Posted: November 1, 2012 - 12:01 am ET
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Several employer groups across the country are calling on health plans and healthcare providers to make healthcare pricing more readily available to their employees and consumers by 2014.

Catalyst for Payment Reform—a not-for-profit organization of large employers and healthcare buyers that includes 3M, Delta Airlines, Dow Chemical Co., the Walt Disney Co. and Xerox Corp.—is directing the effort. In a statement to health plans and healthcare providers (PDF), Catalyst for Payment Reform calls for wider availability of price data for those who use and pay for healthcare. The San Francisco-based group also designed certain specifications that employers and consumer groups can use to evaluate tools that are currently available.

So far, 10 organizations—including the Colorado Business Group on Health, the Leapfrog Group, the National Business Coalition on Health, the National Partnership for Women & Families and the Corporate Health Care Coalition—have endorsed CPR's statement, which lays out two expectations: first, that by January 2014, providers will not restrict health plans from making price and quality information available for use in transparency tools, and second, that by the same time, health plans will give self-insured customers full use of their own claims data.

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"The health plans have made strides in the tools they have created to share quality and cost information with consumers," Sally Welborn, senior vice president of global benefits for Wal-Mart Stores (PDF), said in a news release about the statement. "But when their tools don't meet the needs of employees, employers or other healthcare purchasers should be permitted to engage another vendor who can use that data to build tools that meet their needs."

The statement suggests that accessible information for consumers should include a convenient platform or portal that uses Web and mobile applications combined with support from physicians, nurses or customer service representatives to help patients use the tools properly. It also said self-insured purchasers should find health plan partners that allow the self-insured purchasers to use their own claims data in a way that meets their needs, such as by having the ability to contract with other vendors to analyze and display their data.


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