HHS Pushes Competition With Health Insurance Site - InformationWeek

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Healthcare // Patient Tools
01:35 PM

HHS Pushes Competition With Health Insurance Site

HealthCare.gov hopes transparency on health policy costs, claim denials drives down costs and helps consumers and businesses make better decisions.

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One visitor to the site is Dave deBronkart, known on the internet as "e-Patient Dave." He's a cancer patient who blogs about patient empowerment, including internet use among patients. deBronkart said he likes the idea of publishing health plan price estimates on the site and hopes the site will enable consumers to drive quality and price competition into the health insurance industry, simply so that patients can get better care for themselves and their families.

"In any industry, transparency on price and quality drives things toward the theoretical ideal of perfect competition, because it enables consumers to make better informed decisions," deBronkart said. "At the same time, it gives enormous leverage to vendors who've been busting their butts to do a good job, and accelerates payback for companies who do a good job of worthy innovation. It's win-win-win, except for players whose business strategy is 'I hope nobody finds out.'"

As the website evolves, HHS is also planning to include more information, including the percentage of claims each insurer denies. One can only speculate on how much of an impact that will have on visitors to the site, deBronkart said.

"It depends what significance the individual shopper attaches to the denial rate, and on that I can only speak for myself. If one insurer had by far the best prices but easily the most denials, I'd think perhaps they keep their costs down by not holding up their end of the bargain when the going gets rough," deBronkart said.

One organization expressing caution about publishing each company's claim-denial percentage is America's Health Insurance Plans (AHIP), an organization that represents nearly 1,300 companies providing health insurance coverage to more than 200 million Americans.

"Without proper context that type of information can be misleading for consumers," said Robert Zirkelbach, a spokesperson for AHIP.

According to Zirkelbach some of the claims that are being denied occur when a doctor has submitted an insurance claim to the wrong insurance company, or when a physician files duplicate claims to the same insurance company.

"Those types of administrative errors happens all the time, so without the proper context about what the reasons for those denials are it doesn't tell the whole story," Zirkelbach said.

According to Park, HHS is keenly aware of the concerns AHIP has raised and hopes to allay their fears.

"Every metric that we put on HealthCare.gov we are going to think through very carefully. We are going to think through how to make it understandable to the consumer, and how to put it in the right context, so we are committed to doing that for each and every metric that we put up," Park said.

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