MDSAVE ECOMMERCE TOOL HELPS INSURERS MEET NEW FEDERAL “TRANSPARENCY IN COVERAGE” REGULATIONS

The October 29, 2020 Federal Rule requires that insurers offer patients a tool to research their financial responsibility and both in-network and out-of-network negotiated rates. The MDsave tool, available now, enables 24/7, consumer-friendly price research and allows patients to purchase their care upfront without fear of surprise bills.

BRENTWOOD, Tenn., Oct. 30, 2020 (GLOBE NEWSWIRE) — MDsave, the leading health technology company in transparent, shoppable medical care, announces its ecommerce solution to help insurers meet new transparency requirements issued in an October 29th Final Rule. The Rule, issued jointly by the Departments of Health and Human Services, Labor, and the Treasury, mandates the creation of “an internet-based, self-service tool” that provides “personalized out-of-pocket cost information, and the underlying negotiated rates, for all covered health care items and services,” according to the Transparency in Coverage Final Rule Fact Sheet.

The MDsave transparency tool provides a user-friendly, ecommerce interface that allows patients to instantly purchase a procedure of their choice directly from the website, in addition to enabling personalized cost searches for the required 500 shoppable services and hosting machine-readable files containing all negotiated charges. 

Because each procedure on the MDsave platform includes the most commonly related services and their fees, patients can pay for the entire episode of care upfront without fear of surprise bills.

“Our ecommerce transparency platform is already being implemented for hospitals meeting the January 1, 2021 transparency deadline, so the technology is ready for insurers who want to provide a great patient experience but don’t want to build a tool from the ground up,” explains Greg Born, MDsave President and COO. “We have the platform, the searchability and the transaction capability. All insurers need to provide is the data.”

Insurers must launch their online self-service transparency tools for plan years starting January 1, 2023 for the federally specified 500 shoppable services and plan years starting January 1, 2024 for any remaining services or items.

To learn more, visit MDsave.com/price-transparency. 

About MDsave

Co-located in Brentwood, Tenn. and San Francisco, Calif., MDsave is the world’s first online healthcare marketplace, bringing together patients seeking affordable, reliable care with providers offering high-quality services at fair prices. Using cutting-edge technology, MDsave simplifies the healthcare billing process for patients and providers alike through negotiated rates, bundled pricing and upfront payment. The MDsave marketplace also helps employers and payers offer more value to employees and policyholders with out-of-pocket deductible costs. For more information, visit http://www.mdsave.com.

CONTACT: Kate Steurer MDsave 615-814-6260 [email protected]

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Why Trump’s health care price transparency rules will reignite America’s economy: Art Laffer

In a historic win for all Americans on Thursday, President Trump issued a final rule requiring health insurers to post the prices they have negotiated with hospitals, medical facilities, and doctors. Under this rule, health care consumers, including employers sponsoring workplace coverage, can finally know prices before they receive care. This action will increase competition, lower prices, and save American families money.

Combined with the Trump administration’s already finalized hospital price transparency rule, which requires hospitals to publish the secret rates they negotiate with insurance companies as well as the cash payments they will accept, Thursday’s announcement will usher in a transparent health care sector with less need for the middlemen that have capitalized on patients’ misfortune.

Once these rules delivering complete health care price transparency take effect (January 1, 2021 for the hospital rule and one year later for the insurance rule), we can expect our economy to come roaring back, and our beleaguered health care system to rebound as well.

Knowing the real prices of health care and coverage beforehand will be a huge boon for all Americans–patients, workers, employers and taxpayers.

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Together the rules will unleash a real market in health care, usher in competition and choice, dramatically lowering the costs of care and coverage. Fewer dollars going to health care and more going to wages, jobs and small businesses in our local communities will help boost our nation’s economic recovery.

When complete health care price transparency is in place, patients, consumers, and employers will be able to better shop for health care, and high-tech innovators will eagerly develop tools to help consumers access and compare prices. Better informed buyers of health care will take advantage of the huge price variation that exists in the current, opaque market.

For instance, a recent study from the respected RAND Corporation found employer-sponsored plans are paying hospitals two-and-a-half times more than Medicare pays for the same procedure. Since almost all hospitals accept Medicare, those government rates are by definition “acceptable,” which means hospitals are price-gouging workers and employers, and growing rich at the expense of the middle-class.

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Insurance companies are no better, reaping huge profits as health care costs have soared. The average premium for an employer-provided family health insurance plan in 2020 jumped to $21,300–a 55 percent increase over a decade earlier. During that same time, deductibles more than tripled.

Last year I co-authored a study with health economist Larry Van Horn, it found that cash prices are, on average, 39 percent lower than the insurers’ negotiated rates for the same care. Throughout the country, businesses have saved 30 to 50 percent on health care costs by directly contracting with price transparent doctors and medical facilities, leaving insurers out of the equation.

It’s time to disrupt

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HHS Finalizes Rule on Insurer Price Transparency

WASHINGTON — Private health insurers will have to start posting their prices publicly within the next several years according to a final rule issued Thursday by the Department of Health and Human Services (HHS).

“This shadowy system” of healthcare pricing “has to change; the patient has to be in control,” HHS Secretary Alex Azar said on a phone call with reporters. “That means giving them the right to know what they’re going to owe for a healthcare service before they ever get it.” Right now, however, “patients don’t have the information they need to shop around and get a good deal … and have an informed conversation with their doctor about what makes sense for them.”

The final rule — which was issued by HHS together with the Labor and Treasury departments — would require almost all private health insurance plans to give the 200 million Americans they cover real-time access to information about negotiated prices and cost-sharing, beginning with a list of the 500 most “shoppable” services in 2023, Azar said. This list would be expanded to include all healthcare services in 2024. “This is information that patients typically receive after they get those services, through an EOB [Explanation of Benefits] form,” but now they could get it ahead of time.

Through a shopping tool available through their plan or insurance company, consumers will be able to see the negotiated rate between their doctor and their plan or insurer, as well as the most accurate out-of-pocket cost estimate possible based on their health plan for procedures, drugs, durable medical equipment, and any other item or service they may need, HHS said in a press release. “Consumers will also have access to accurate price and plan information that allows them to shop and compare costs between individual doctors before receiving care, so they can choose a healthcare provider that offers the most value and best suits their medical needs.”

In 2022, a year before the real-time access provision takes effect, insurers will be required to publish their negotiated rates in data files that will be searchable by patients, employers, researchers, and app developers who could then develop tools to help patients choose their providers. “The vast majority of patients don’t have easy access to this information today,” said Azar.

“In one study when prices for imaging were made transparent, the prices dropped almost 20%,” he said. “You should have the right to know what a healthcare service is going to cost, and the right to know what it’s going to cost you out-of-pocket. That’s what today’s rule will do.”

For each insurer, three data files will be available: one with prices for in-network providers and services, one with prices for out-of-network providers and services, and another for in-network prices for all prescription drugs.

HHS giving insurers a lot of time to comply with the new rule “reflects that there’s a lot of work involved, but that work is only necessary because entrenched special interests in the healthcare system have for

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