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Health Plans’ Cost Comparison Tools Helping Consumers Navigate The Health System

posted by Clare Krusing

on February 17, 2016

For Immediate Release

Washington, D.C. – As consumers take a more active role in their health decisions, health plans are providing enhanced cost and quality comparison tools for individuals and families to make informed choices about their care. According to a new study from America’s Health Insurance Plans (AHIP), published in The American Journal of Managed Care (AJMC), nearly all health plans with price transparency tools provide their members with estimates for commonly used procedures such as inpatient and outpatient surgeries (97 percent).

Research shows that the availability of price information can help consumers make health care decisions tailored to their specific care needs. Through these price comparison tools, health plans are supporting patients as they navigate the health care delivery system and improving access to affordable, high-quality care.

While many of these tools are tailored to enrollees’ specific benefits, the study examines the common characteristics of price estimator tools in commercial health plans to identify trends, challenges, and potential ways to increase patients’ use of these resources.

Key findings from plans providing price estimator tools include:

  • 94 percent of plans allowed consumers to comparison shop for their providers;
  • Two-thirds of responding plans shared provider performance data with their enrollees.
  • 58 percent of plans provided cost estimates for prescription drugs;
  • 90 percent of plans displayed potential out-of-pocket costs, such as co-pays, coinsurance, and deductibles, an enrollee might incur for specific procedures or services.

To view the full study, click here.


About the Journals and AJMC.com

The American Journal of Managed Care is the leading peer-reviewed journal dedicated to issues in managed care. AJMC.com distributes healthcare news to leading stakeholders across a variety of platforms. Other titles in the franchise include The American Journal of Accountable Care, which publishes research and commentary on innovative healthcare delivery models facilitated by the 2010 Affordable Care Act. AJMC’s Evidence-Based series brings together stakeholder views from payers, providers, policymakers and pharmaceutical leaders in oncology and diabetes management. To order reprints of articles appearing in AJMC publications, please call (609) 716-7777, x 131.

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Providing Health Benefits for Over 200 Million Americans.