Evaluating Cost Estimator Tools for ConsumersNYHealth awarded Consumers Union a grant to assess health insurers’ cost estimator tools in New York State and identify how they can be improved.
Empowering Health Care Consumers
June 2015 – February 2016
Now more than ever, there is a demand for cost transparency in health care.
One mechanism to offer greater transparency are cost estimator tools provided by health plans, which are commonly found on their websites. These cost estimator tools can be a valuable resource for plan members, giving them access to real-time price information of in-network providers and a sense of what they will have to pay for a service or procedure. In 2012, Massachusetts passed a law requiring that all insurance companies provide their members with estimated prices for health care services, a measure that other states, including New York, are considering. An advocacy coalition in Massachusetts published a report card of those tools in 2015, finding significant variation by health insurer. Although insurers’ cost estimator tools are a unique resource for price transparency, variation in quality suggests that access to the best price information may depend on one’s coverage. NYHealth awarded Consumers Union a grant to assess health insurers’ cost estimator tools in New York State and identify how they can be improved.
Outcomes and Lessons Learned
- Evaluated health insurers’ cost estimator tools, as well as other public tools not affiliated with a health plan, examining the usefulness, consumer experience, scope, and accuracy of each tool;
- Conducted user testing with plan members to assess to their experiences with cost estimator tools, which found that although only 12% had previously used such tools, 75% would recommend their usage after they had engaged with them;
- Published ratings and results—both nationally and New York State-specific—in Consumer Reports, reaching 425,000 print and online subscribers in New York State;
- Produced an issue brief that provided more analysis of cost estimator tools available to New Yorkers, including user experience feedback and recommendations on how health plans and policymakers can improve the availability and quality of such tools; and
- Conducted a webinar for health insurer members of the New York Health Plan Association.
In January 2018, New York State Governor Cuomo released his State of the State, with proposed policy recommendations for the year. In it, he highlighted the need for improved price transparency in health care and recommended that the State’s health insurance regulatory agency, the Department of Financial Services, require New York health plans to implement cost estimator tools.
Co-Funding and Additional Funds Leveraged: N/A