Massachusetts transparency efforts help control costs

Nov 7, 2014 | Healthcare Industry News

Since last month, Massachusetts residents have been encouraged to shop around for the best prices. However, they aren't looking for the best Black Friday deals, but rather for MRIs, medical tests and the lowest co-pays. 

In October, the Bay State rolled out sweeping payment reform legislation designed to improve health care quality while keeping costs in check. One of the most impactful elements of the legislation is a law that requires Massachusetts health insurers to make all their prices public, including any hidden fees or facility costs. The state then shares the information with the public in a health care cost transparency tool. 

With the rising popularity of high-deductible plans that transfer significant costs to the patient, health care consumers have strong incentive to shop around for the best prices. But the tool has also apparently had affects on health care providers. 

"They're already saying, 'I don't want to be the highest priced provider on your website — I thought I was lower than my competitors.' That's exactly the kind of reaction we want to see," Barbara Anthony, undersecretary for consumer affairs in Massachusetts told NPR. 

Anthony explains that the transparency efforts are key in understanding why some facilities can charge exponentially more than others for the same service, and whether that practice will be able to continue once patients are better able to anticipate the cost of care. 

When patients are surprised by the total cost of their treatment, health insurance claims follow-up professionals may encounter problems associated with rising bad debt. The decision to outsource receivables management can help avoid these challenges, as well as promote a stronger patient-provider relationship.