Wisconsin is a national leader in health care transparency, being one of the first states in the nation to develop online resources to voluntarily share information that will help consumers compare hospital charges.
On October 10, WHA announced the release of its newest version of PricePoint (www.wipricepoint.org), an online resource that allows consumers to compare hospital-specific charges and other financial data associated with the care provided for a particular procedure or condition in Wisconsin hospitals and Medicare-certified ambulatory surgery centers. (See Infographic here.)
The latest version of PricePoint improves the user experience by using a series of questions to gather important information about their health care situation, including whether or not they have insurance. The tool then provides users with the estimated charges for services that are typically associated with conditions or treatments similar to their own.
PricePoint encourages consumers to use the information as a starting point for an informed discussion with the hospital, their doctors and their insurance company. It emphasizes that the insurance company is the best source for information on out-of-pocket costs to satisfy deductibles and co-pays.
As people assume more financial responsibility for their health care decisions, they need information about the price and quality of medical services they may receive, according to WHA President/CEO Eric Borgerding.
“We’ve made a lot of progress in the area of health care price transparency, but we know there is still much to be done,” according to Borgerding. “In 2016, more than 220,000 people in Wisconsin purchased private insurance on healthcare.gov, the federal insurance exchange. Those with employer-sponsored insurance are seeing changes in their deductibles and co-pays. We understand that more information is needed to make informed choices, and Wisconsin hospitals and health systems want to help by providing as much information up front as possible about the cost of care. PricePoint is one more tool that we think helps consumers with their health care decisions.”
A report from the national Healthcare Financial Management Association and the American Hospital Association said health plans should be the primary source of price information for their members, while hospitals should be the prime contact for those without insurance or who are out of network.
“It’s not possible or practical to compare prices for all services in advance, but for elective surgery and diagnostic procedures, PricePoint offers consumers an opportunity to see the ‘sticker’ price before making a decision about their care, and then it offers guidance on who to contact, which is usually the insurer, to determine their out-of-pocket expenses,” according to WHA Senior Vice President and COO Brian Potter.
The newest release of the PricePoint website builds on Wisconsin hospitals’ commitment to make hospital costs and billing policies more transparent. Developed and launched by the WHA Information Center (WHAIC) in 2005, the PricePoint web-based platform is now licensed for use in 10 states. Wisconsin hospitals also share quality-related information at www.WiCheckPoint.org.
The WHAIC collects data from Wisconsin hospitals, including hospital-specific charge information on hundreds of procedures and conditions. While more than 95 percent of the patients in Wisconsin have insurance coverage and do not pay the full price of their care, charges are a starting point for a conversation between the patient, their health care provider, and their insurance company about the cost of a specific treatment or procedure.
The hospital and ambulatory surgery center data on PricePoint is collected and published by the WHAIC. The WHAIC has collected and disseminated complete, accurate and timely data about charges and services provided by Wisconsin hospitals and ambulatory surgery centers since 2004. The newest release of PricePoint also uses data provided by the Wisconsin Health Information Organization (WHIO). The WHIO data provides information related to fees from physicians and other health care professionals involved in direct patient care, rehabilitation, skilled nursing, and ancillary and pharmacy services.