Transparency defined Featured

8:00pm EDT September 20, 2006
Looking for a new house. Finding the perfect gift for a friend’s birthday. Shopping for a new car. When making these types of purchases, consumers have access to a wealth of information, with the majority now available via the Internet.

Although purchasing health care is a different type of decision from these examples, having the right information available is just as essential a part of the process. This is especially true as consumers take a more active role in the overall health care process. And a recent study found that Americans are demanding more and better information on health care costs, with 84 percent wanting to know the price of health care.

“As the popularity of consumer-directed plans increases, it is the insurers’ responsibility to give consumers more information on both the cost and quality of health care,” says Bill Berenson, vice president of sales and service for Aetna’s Small & Middle Market Business in the North Central Region. “This way, they can make more informed, educated health care decisions.”

Smart Business spoke with Berenson, who answered some questions on transparency in health care and how innovations in this area may significantly impact the entire health care system.

What does transparency in health care mean?
This means making information available to consumers, that previously was not available to them. This may include the prices for common health care services with a specific physician, as well as clinical quality and efficiency information on physicians.

Transparency in health care is an integral part of the consumer-directed movement. If we are asking consumers to make health care decisions they have not had to make in the past, we must give them the information they need to make educated decisions for themselves and their families.

Do insurers want consumers to make decisions solely based on the price of services and care?
Absolutely not. Pricing information should be used as one of many resources in the decision-making process, along with data on the clinical quality and effectiveness of the care provided. First and foremost, consumers should make a decision based on where they believe they will receive the best care. However, we think it is important for them to have pricing information prior to making this decision, so that they can understand the full financial impact of their choices.

Do all insurers offer cost and quality information to their members?
This is a relatively new and innovative idea in health care, and because of this, not all insurers offer this information to their members (and even those that do may only offer it in certain regions of the country). It is important for employers to find out from their respective insurers if this type of information is available for their employees.

How do doctors and other medical providers feel about transparency?
When instituting a transparency-related initiative, it is extremely important to incorporate feedback and input from the physicians. Most physicians want enough information available to their patients so that they can make a decision based on the overall value of the care, and not simply the price alone.

How does transparency impact employers?
Transparency may have its biggest impact on employers as they shift toward consumer-directed plans. As mentioned previously, providing quality, easy-to understand information to consumers is an essential part of the consumer-directed movement. Transparency not only provides this type of information, it also demonstrates the insurers’ commitment to both the employer and their respective employees.

While transparency is just one part of a broader commitment to helping consumers make well-informed health care purchasing decisions, it is an exciting and innovative aspect of the process. The health-related choices we make for our families and ourselves are some of the most important, and with these types of initiatives becoming more prominent with insurers, consumers will soon have a greater ability to truly find value in the health care they receive.

BILL BERENSON is vice president of sales and service for Aetna’s Small & Middle Market Business in the North Central Region. Reach him at (312) 928-3323 or berensonw@aetna.com.