SUMMARY: Remember that Florida hospital chief who promised to post all his hospital’s contracted rates with all its insurance companies? Well, not so fast. It hasn’t happened, and it’s not likely to.
It was about a year ago that Steve Sonenreich, president and CEO of Mount Sinai Medical Center in Miami Beach, Fla., made his promise in a radio interview. Bob Herman at Becker’s Hospital Review caught up with the story the other day and explained why it hadn’t happened — and why it probably won’t.
You won’t be surprised to hear that America’s Health Insurance Plans, the trade group for the insurance industry, believes that revealing the prices is bad for business, bad for providers and bad for people.
“Despite Mr. Sonenreich’s pledge to publish private payer rates, those confidential terms within the contracts — what he calls a ‘gag clause’ — have prevented his institution from doing so. Mount Sinai officials contacted all of their insurance carriers to release the information, but the insurers refused to grant Mount Sinai permission to disseminate the rates,” Herman writes.
” ‘They thought it was a challenge to strategic market information,’ he says. ‘We believe there’s a direct correlation between the lack of transparency and the increase of insurance expenses.’
“However, private health insurers have argued provider rates have nothing to do with the consumerism-focused push for price transparency. Susan Pisano, vice president of communications for America’s Health Insurance Plans, says if the rates that insurers pay to providers were made public, it would ‘inhibit competition.’ She says it could potentially encourage hospitals to demand the highest reimbursements in a given market, which would not benefit patients.
” ‘Consumers care about two things: quality of provider and what it is they are going to have to pay out of pocket,’ Ms. Pisano says. ‘That’s the information that is useful to consumers. The behind-the-scenes information isn’t useful to them.”…
” “Insurance companies and providers sign contracts, we all do, that do not allow us to disclose our prices,’ Mr. Sonenreich adds. ‘The only way we find out this kind of information is when our employees wind up in another institution. And it’s shocking. We believe that transparency would save employers and employees — and our country — money, and it would substantially reduce the expense of health insurance coverage.” via Post Your Price: It’s Not So Simple for Hospital Executives.
