August 10, 2022
HBCH Executive Director Testifies Before
House Select Committee on Healthcare Reform
In this Issue

HBCH Executive Director Testifies Before House Select Committee on Healthcare Reform

NEW Transparency Tools to Support Employers

Health Plan Transparency Requirements

The Healthcare Digital Dilemma
Events of Interest
HBCH Executive Director, Chris Skisak, PhD, testified on August 4 to the Texas House Select Committee on Healthcare Reform in advance of the 88th Texas Legislative session that begins January 2023. 
 
He spoke to the impact of hospital price inflation on employers and employees. Questioning by Committee members, made it clear that change is unlikely without the employers voice of concern to legislators.
 
The charge to the Committee was threefold:

  1. Study the implications of excessive healthcare costs.
  2. Monitor the implementation of, and compliance with, current price transparency requirements.
  3. Evaluate innovative, fiscally positive options to ensure access to affordable quality and comprehensive healthcare.
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 Dr. Skisak’s testimony concluded three findings:

  1. Rising health care costs place pressure on employers and worker wages
  2. Employers need transparent information (cannot place burden on employees)
  3. Where markets have failed because of anti-competitive behavior, policymakers have a responsibility to prohibit anti-competitive contracts and billing, and restore healthy competition.
NEW Transparency Tools to Support Employers

Hospital transparency remains a key focus area for HBCH.  Much local and national attention has been directed towards the price employers pay for hospital services. A majority of employers pay more than 250% of the Medicare price for the same service at the same physician and the prices paid equate to more than 100% of the financial breakeven price for hospitals. The hospital industry is entitled to and must make a reasonable profit to support its community mission. However, employers should not be asked to pay an unjustified healthcare “tax” at the expense of business growth, family quality of life, and resources for other local community needs. 
 
HBCH has provided a resource in the Hospital Transparency section of its website to help all healthcare stakeholders better understand hospital prices and to support future contract negotiations and benefits design. Contact chris.skisak@houstonbch.org if you need support to navigate any of these tools.
 
 
  • RAND Hospital Price Transparency – provides a comparison of what the employer pays for hospital services compared to the price Medicare pays that same hospital and provider for the exact same services.

  • National Academy for State Health Policy Hospital Cost Tool – provides state policymakers and researchers with analytical insights into how much hospitals spend on patient care services, and how such costs relate to the hospital charges (list prices) and actual prices paid by health plans.

  • Sage Transparency Dashboard – provides price and quality information from multiple sources in an easy to understand and view format.

Health Plan Transparency Requirements

The National Alliance of Healthcare Purchaser Coalitions provides a 1-page summary with resource links on the Departments of Labor, Health and Human Services (HHS) and the Treasury Transparency in Coverage (TiC). The TiC Final Rules set forth requirements for all group health plans and health insurance issuers in the individual and group markets to disclose cost-sharing information upon request to a participant, beneficiary, or enrollee.
 
The requirements of the TiC rule will be phased in in three stages:

  1. The first phase consists of posting on a public website two machine readable files. One for rates for all covered items and services between the plan or issuer and all in-network providers, and one all allowed amounts for, and billed charges from, out-of network providers. (Effective July 1, 2022)
  2. The second phase consists of an internet-based comparison tool allowing patients to receive estimates of their cost-sharing responsibilities on 500 services. (Effective 2023)
  3. The third phase is to expand the internet-based tool to all items and services. (Effective 2024)

The Healthcare Digital Dilemma
Wednesday, September 21, 8:00 am - 11:30 am CST -
The Friedkin Group
1375 Enclave Pkwy, Houston, TX 77077
 
REASONS TO ATTEND
 
·   Learn how digital technologies are transforming delivery
·   Learn what to expect in terms of cost reduction and outcomes
·   Learn how others support and enhance traditional in-person care