Recently, payers and providers have been engaging in a slew of transparency campaigns, with some aiming to “expose” pricing and denial concerns.
For example, Hospital Watch has come to the forefront, shifting blame to hospitals.
“Hospital Watch is a watchdog group dedicated to shining a light on corporate hospitals as the top culprit in driving up U.S. healthcare costs — exposing corporate hospitals’ monopolistic practices in price gouging patients with excessive markups and hidden fees with no transparency while forcing patients and employers to pay more for their care,” the group’s website says.
While Hospital Watch said its focus is corporate hospitals, a map showing payment incidents across the U.S. also features nonprofits and academic medical centers. Better Solutions for Healthcare — which includes the BCBS Association and AHIP as members — oversees the project, and former congressional staffer Adam Buckalew advises.
BCBS Vermont was behind the Vermont Affordable Care campaign, consisting of a website and local ads. The initiative focuses on comparing pricing at academic medical centers and independent facilities. A spokesperson for BCBS of Vermont previously said the effort aims “to educate.”
Insurers are not the only ones launching such campaigns. The Indiana Hospital Association’s Access Denied initiative focuses on care denials and intends “to expose abusive insurer practices.” IHA President Scott Tittle advocated for legislative reform, pointing to a state bill that would prevent imposing penalties on facilities using out-of-network providers, as well as another that would restrict downcoding, block retroactive payment rate reductions and limit clawbacks.
Despite IHA’s efforts, Elevance Health — one of the campaign’s main targets — said it is engaging in “collaborative work with providers” to lower costs.
In an interview with Becker’s, BCBS Vermont President and CEO Beth Roberts said she admires her team’s consumer awareness work, which predates her appointment. While Lebanon, N.H.-based Dartmouth Health told Becker’s it did not know about the campaign at the time, Ms. Roberts said she has been in affordability talks with University of Vermont Health CEO Stephen Leffler, MD. The campaign claimed UVM Medical Center was the most expensive listed facility as of Oct. 1, followed by Dartmouth Health.
Becker’s contacted Mr. Buckalew’s strategic advisory firm, ALB Solutions, and will update this story if more information becomes available.
