![]() In their decision, the justices provided a pathway for the Department of Labor (DOL) to restore this state function. Practically speaking that may mean that in certain geographies there simply aren’t enough non-self-insured plan members to provide reliable comparisons of provider costs, in particular when looking at episode costs and not individual services. Liberty Mutual Insurance Company allowed all self-insured employers, who sometimes represent more than half of all commercially insured individuals in a state, to be exempt from having their claims submitted to state-legislated all-payer claims databases. There are currently two sources of information blocking that prevent residents in states across the country-even those with state transparency laws-from having access to the full complement of claims data that could inform price transparency efforts.įirst, the US Supreme Court ruling in Gobeille v. The focus of this post is on other important issues that need to be addressed. Many of the questions that the senators ask have already been answered in a report published by the Health Care Financial Management Association and in a prior post on the Health Affairs Blog. The senatorial request for information on how potentially to solve that problem is therefore timely and important. Having co-authored that report for years, it’s clear that there has been some progress, and yet most Americans still don’t have a reliable source of information on the prices of health care, whether from the state they live in or their health plan. In their letter, the senators led by Bill Cassidy (R-LA) reference the annual Price Transparency Report Card that the Health Care Incentives Improvement Institute and the Catalyst for Payment Reform have published and that shows the low level of adoption of price transparency in the United States. In late February 2018, a group of US senators co-signed a letter to stakeholders seeking answers to questions that centered on how to achieve greater pricing transparency.
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