By Pension and Benefits Editorial Staff
Several employer groups have released statements applauding the Trump Administration’s recently-released final rule on provider cost-sharing transparency, saying the final rule will help lower employer costs. The groups include the American Benefits Council, the ERISA Industry Committee (ERIC), and the HR Policy Association. America’s Health Insurance Plans (AHIP) disagrees and believes the final rule will actually increase health care costs for employers.
Final rule. The Departments of the Treasury, Labor, and Health and Human Services issued final rules that set forth requirements for group health plans and health insurance issuers in the individual and group markets to disclose cost-sharing information upon request to a participant, beneficiary, or enrollee, including an estimate of the individual’s cost-sharing liability for covered items or services furnished by a particular provider. Note that the rules do not apply to grandfathered health plans, health reimbursement arrangements or other account-based group health plans or short-term, limited-duration insurance. The final rule is scheduled to be published in the November 12 Federal Register.
Employer groups. According to the American Benefits Council, greater price and quality transparency in health care will improve value and reducing health care costs. “Everyone who pays for health care in this country—individuals, employers and the federal government—needs to know that they are getting good value for their money,” said Katy Johnson, American Benefits Council senior counsel of health policy. “Price transparency is an important part of the value equation and [the] final regulations will significantly increase the price information available to employees and their families.”
ERIC noted that the final rule will help lower health care costs and ensure that patients receive the best care at fair prices, without any surprises, by requiring health plans and employers to post online out-of-pocket costs and negotiated rates.
“The regulation comes not a minute too soon, as millions of Americans are struggling to pay inflated health care costs. Price transparency will empower patients to make more informed decisions while also driving competition among health care providers, reducing health care costs, and improving the quality of care,” said James Gelfand, senior vice president of health policy at ERIC.
The HR Policy Association said that the final rule will enable employers to utilize publicly available health care price data to reduce unnecessary spending and increase the quality and value of their health care benefits. While the “cost of the disclosure requirements will likely be passed onto employers,” the increase in transparency “will enable large employers to substantially improve value-based care and better control health care spending in the long run,” the organization wrote.
AHIP. According to Matt Eyles, president and CEO of AHIP, “We are disappointed that the final rule will work to reduce competition and push health care prices higher, not lower, for American families, patients, and taxpayers. This is precisely the opposite of what Americans want in their health care.”
AHIP believes that the final rule’s approach is flawed, because “disclosing privately negotiated rates will reduce incentives to offer lower rates, creating a floor—not a ceiling, for the prices that drug makers, providers, and device makers would be willing to accept.”
SOURCE: www.americanbenefitscouncil.org; www.eric.org; www.hrpolicy.org; www.ahip.org
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