How Much Health Insurers Pay for Almost Everything Is About to Go Public

Guidehouse expert Jeff Leibach discusses the impact of the new payer price transparency rules on consumer choice and provider strategy in Kaiser Health News.

As of July 1, health insurers and self-insured employers must post on websites just about every price they’ve negotiated with providers for healthcare services, item by item.

The new rules are far broader than those that went into effect last year requiring hospitals to post their negotiated rates for the public to see. Now insurers must post the amounts paid for “every physician in network, every hospital, every surgery center, every nursing facility,” said Jeffrey Leibach, a partner at Guidehouse. “When you start doing the math, you’re talking trillions of records,” he said. The fines the federal government could impose for noncompliance are also heftier than the penalties that hospitals face.

Federal officials learned from the hospital experience and gave insurers more direction on what was expected, said Leibach. Insurers or self-insured employers could be fined as much as $100 a day for each violation, for each affected enrollee if they fail to provide the data. “Get your calculator out: All of a sudden you are in the millions pretty fast,” Leibach said.

Read the full story in Kaiser Health News.

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