There is always a feeling of uncertainty when you go to the doctor, urgent care, or hospital, especially when it comes to the out-of-pocket costs that you might have to pay as a result of the visit. While it is common practice to “shop” for the best deal on cars or houses, the health insurance industry, “which accounts for nearly 20 percent of the economy,” has provided little to no access to precise information on just how much a particular service or procedure may cost prior to scheduling an appointment.
In a market with rising premiums and costs for services, many people are left making uninformed financial decisions and then having to live with whatever appears on the bill they are mailed weeks later. According to the Kaiser Family Foundation, nearly 47 percent of Americans struggle to afford their health care costs. However, after years of effort from both sides of the isle, the curtain has finally been pulled back to shed light on pricing and provide cost transparency for consumers.
In July 2022, the No Surprises Act was passed, which requires physicians to deliver a “good faith estimate” that will include all costs a consumer would “reasonably expect” to be part of the treatment, offering more context than ever to make informed decisions about their care. This is a step forward towards a more competitive marketplace. Competition, as we know, is good for the consumer and will hopefully deliver lower out-of-pocket costs over the coming years. Along with the No Surprises Act, additional requirements and policies will be effectuated in January 2023 and 2024 to provide additional tools to boost Americans ability to shop and make decisions on their health care that best fit their needs.
One piece of the transparency battle that is particularly important is hospital price transparency. Many Americans have experienced just how quickly hospital bills can rack up with a trip to the hospital. With hospital price transparency, hospitals operating within the U.S. must produce publicly accessible information about the items and services they provide and the standard cost, including a “comprehensive machine-readable file with all items and services” and “display of 300 shoppable services in a consumer-friendly format.” These standards will be monitored and facilities will be held accountable if they fail to adhere in the form of civil and/or monetary penalties.
As more and more transparency is given to the American public, we should begin to see an increasingly competitive Marketplace. It is important to do your homework to ensure that you are making the best financial decisions for yourself and family when it comes to your health. The agents at ARC Benefit Solutions are here to help you sort through your options and find a plan that works best for you.