Is a lack of awareness about healthcare costs failing your employees?
Per capita health care spending is at an all-time high, topping off at more than $11,500 per person in 2019.1 But though health care costs make up a significant proportion of many household budgets, a 2019 survey revealed that only around one in four respondents (or 27 percent) take advantage of tools to comparison shop for various procedures and healthcare services.2
It can be difficult to get straightforward information about the potential costs associated with medical treatment. This lack of transparency can be compounded by a lack of awareness—many people simply don't realize they're entitled to know how much healthcare services will cost. Below, we'll discuss how the recent enactment of the No Surprises Act may make it easier for individuals to access healthcare costs, as well as what you as an employer can do to help your employees shop around for healthcare procedures.
The No Surprises Act
In July 2021, three federal agencies—the Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Department of the Treasury published an interim final rule that implements much of the No Surprises Act. The No Surprises Act is intended to limit patients' responsibility for paying some unavoidable out-of-network service costs, as well as prohibit healthcare providers and facilities from imposing balance billing for certain services.
For example, a patient who is unconscious may not be able to consent to out-of-network treatment—and since their health insurance is unlikely to cover out-of-network services at the same rate as in-network services, the patient could receive a bill for the difference. This "balance billing" is restricted by the No Surprises Act, which limits the ability of out-of-network emergency services providers to send a bill to the patient for certain amounts over the in-network cost-sharing responsibility of the same service.
The Act also sets forth price transparency disclosure requirements for both healthcare providers and health insurers, helping make it easier for consumers to make apples-to-apples comparisons of certain medical procedures. Finally, the Act requires insurers to create dispute resolution processes so that patients can address any surprise medical bills directly with the provider and insurer themselves.
How Employers Can Help
Many health insurance plans offer their own cost-comparison tools, which can make it relatively simple to compare the cost of a procedure or treatment across two or more providers. If your insurance provider has such a tool, make sure your employees are aware that they can use it to save significant money on healthcare expenses.
If your insurance provider doesn't have a cost-comparison tool, you may be able to direct employees to online healthcare price comparison tools like CarePay, which gathers prices from multiple sources.3 Simply typing in your zip code and the desired service can reveal a long list of providers in your area and what they'll charge for this service. Again, it's crucial to educate your employees on how they can access this information.
This blog is up to date as of September 2021 and has not been updated for changes in the law, administration or current events.