Transparency

See Transparency under Cost Containment for evidence on the benefits and costs of various approaches to increasing price and quality transparency to consumers. This section is restricted to discussion of federal and state health reform policy proposals related to increasing transparency that are  under discussion and not yet adopted or implemented as well as private sector inititatives to promote transparency. This includes ideas that may have been adopted in other countries or other settings (e.g., large health plans or selected states), but that have been proposed to be significantly expanded to other U.S. populations under comprehensive health reform.

Links

  • Transparency (Health Affairs search)
  • FH Medical Cost Lookup. The FH Medical Cost Lookup offers information on estimated costs for healthcare professionals’ services for medical procedures, including a limited number of anesthesia services available on FH Estimate Assist®. At this time the website does not include charges for durable medical equipment or separate facility fees, which may be billed in addition to healthcare professional fees, when services are performed in a hospital, freestanding clinic, or other treatment center. Over time, the FH Medical Cost Lookup will be expanded to include this information. The data is based on 15 billion medical claims from 70 private health and dental insurers.
  • Healthcare Blue Book. The Healthcare Blue Book is a free consumer guide to help you determine fair prices in your area for healthcare services. If you pay for your own healthcare, have a high deductible or need a service your insurance does not fully cover, we can help. The Blue Book will help you find fair prices for surgery, hospital stays, doctor visits, medical tests and much more.
  • Private Insurers. Price tools typically are for members only.
    • Aetna. Aetna members can use Aetna Navigator to find:
      • Estimated average costs in your area for certain office visits, diagnostic tests, vaccines, and surgical and scope procedures (“Scope” refers to an instrument used to examine an inner part of the body and, with an attached instrument, to perform a biopsy or surgery.)
      • Estimated average costs in your area for certain dental procedures (if you are enrolled in an Aetna dental plan)
      • Annual estimated average costs in your area for treating specific diseases and conditions
      • Costs for specific brand and generic drugs filled at participating retail drug stores or ordered through Aetna’s mail order program (if you are enrolled in an Aetna pharmacy plan)
    • Cigna. Cigna allows customers to assess medical costs – including specialist, facility and related fees – according to the real-time status of their health plan deductibles and co-insurance, as well as their available health spending account funds, before choosing their physician.
    •  UnitedHealthcare. The myHealthcare Cost Estimator provides cost estimates to members based on available fee schedules or contracted rates (when fee schedules/contracted rates are not available, estimates are based on claims averages for the particular provider).
  • State Public Databases.  Some states offer public databases of hospital pricing information, such as Maine HealthCost.

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