PBN Health Care Summit: Price transparency a challenging objective for industry

PROVIDENCE BUSINESS NEWS EDITOR Mike Mello, left, leads the discussion at PBN's Health Care Summit on Wednesday. Participating on the panel are, from left, Marc Backon, president, commercial division, at Tufts Health Plan; Stephen Farrell, CEO of UnitedHealthcare of New England; Marie L. Ganim, R.I. Health Insurance Commissioner, Kim A. Keck, CEO and president of Blue Cross & Blue Shield of Rhode Island; Dr. Alan Kurose, CEO and president of Coastal Medical; and Neil D. Steinberg, CEO and president of Rhode Island Foundation. / PBN PHOTO/MIKE SKORSKI
PROVIDENCE BUSINESS NEWS EDITOR Michael Mello, left, leads the discussion at PBN's Health Care Summit on Wednesday. Participating on the panel are, from left, Marc Backon, president, commercial division, at Tufts Health Plan; Stephen Farrell, CEO of UnitedHealthcare of New England; Marie L. Ganim, R.I. Health Insurance Commissioner, Kim A. Keck, CEO and president of Blue Cross & Blue Shield of Rhode Island; Dr. Alan Kurose, CEO and president of Coastal Medical; and Neil D. Steinberg, CEO and president of Rhode Island Foundation. / PBN PHOTO/MIKE SKORSKI

PROVIDENCE – Health care needs more price transparency, but how to address the issue remains a challenge, panelists at the Providence Business News 2019 Fall Health Care Summit said Wednesday.

While most insurers already have the tools to share cost information, and pass them along to members and providers, price distributions typically aren’t widely used, said Kim Keck, CEO and president of Blue Cross & Blue Shield of Rhode Island.

The challenge is that patients who already need a service aren’t likely to cost-compare when they have a health issue that needs to be addressed.

“People don’t really shop for services once you’re in a hospital,” Keck said.

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National efforts headed by the Centers for Medicare and Medicaid Services and the U.S. Department of Health and Human Services to require hospitals to publicize list prices may not have a significant impact on affordability for that reason, she said.

“There’s a lot of good policy conversation that I think is going to need some support, but I think if we’re not careful we’ll just create additional transparency that doesn’t add a lot of value,” Keck added.

Keck was among the two-session summit’s first group of panelists. She shared the stage with: Marc Backon, president of Tufts Health Plan’s Commercial Division, Stephen Farrell, CEO of UnitedHealthcare of New England, Marie Ganim, R.I. Health Insurance Commissioner, Dr. Alan Kurose, CEO and president of Coastal Medical, and Neil Steinberg, CEO and president of the Rhode Island Foundation.

Ganim cited a recent study by Massachusetts Attorney General Maura Healey that found price transparency without specific intent is not very useful.

“I think it really depends on how you do it,” she said.

Simply listing prices for services and medications fails to address a complicated issue that includes effective use of resources, Farrell said.

“We believe that it’s a complicated solution, and it’s a solution that means we have to connect the communication to the consumer, along with the communication to the provider, and bring them together in arrangements like plan designs and strategies and accountable care organizations where the better performance can be understood and … where the consumer can make that decision.”

Such conversations are likely best between patients and physicians, who are often the best source of quality information for patients, Kurose said.

Still, changing the availability of information and making it easier to weigh quality and outcome versus price in terms of patients’ insurance coverage is a slow process. The ultimate goal, Kurose said, should be to make such discussions possible between a doctor and patient in an exam room.

“That’s a really sophisticated analysis that has to take place in real time,” Kurose said. “I know that’s a long trip but I also know that payers are working on it.”

Discussion during the first session also touched on the current focus of the R.I. Health Care Cost Trends Steering Committee, the R.I Reinsurance Program, how the withdrawal of federal funds from HealthSource R.I. may impact businesses, whether accountable care organizations have fallen short of their savings targets and insurer-provided incentives for choosing cost-efficient providers.

The second panel of the morning, moderated by Steinberg, was a fast-moving discussion that ranged from the possibilities of additional hospital mergers in the state to the challenges of cybersecurity in the health care system to Gov. Gina M. Raimondo’s temporary ban on flavored vaping products.

Dr. James Fanale, CEO of Care New England, which runs Butler Hospital, Kent Hospital, and Women & Infants Hospital, said he believes further consolidation within the health care system is inevitable. But after recent efforts to link with Partner’s HealthCare in Massachusetts, and then with Lifespan in Rhode Island both failed, Fanale said Care New England is taking a break.

“It’s a situation of scale … Is it always the case that the bigger you get, the better you’ll be? Not necessarily. It’s whether you can deliver the product at a lower price point and still improve quality,” he said.

When the question of the state’s temporary ban on flavored e-cigarette products came up, James Rajotte of the Rhode Island Department of Health pointed out there is ongoing litigation over the issue, so he couldn’t say too much.

Rajotte, chief of the Center for Health Promotion in the Division of Community Health and Equity at DOH, said the state is considering potential regulations after the temporary ban is lifted, including age restrictions on product sales, limits on the quantity purchased, warning labels and more.

He also emphasized the importance of education within the family. “This is a discussion that needs to start at the kitchen table,” he said.

With the health care system increasing dependent on computers, cyber-security is more and more worrisome to health care executives. “It’s a scary topic,” said Fanale, who noted that Care New England is trying to build more and more protections into its systems.

“I’m worried about the continuity of care if there’s ever a cyberattack … It could take us down to nothing,” said Maria Ducharme, senior vice president of Patient Care Services at The Miriam Hospital in Providence. “That’s what keeps me up at night.”

Elizabeth Graham is a PBN staff writer. Andy Smith is contributing writer.

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