Monday, January 4, 2021

Treasurer Folwell Applauds U.S. Court Decision on Health-Cost Transparency Cites UNC Health’s New Cost-Estimator Tool as an Example of Good Practices

Jan 4, 2021

(Raleigh, N.C.) – State Treasurer Dale R. Folwell, CPA, today applauded a court ruling  upholding the Trump administration’s executive order improving price and quality transparency in America’s health care. The order requires hospitals that take Medicare patients to disclose the secret rates for medical services that they negotiate with insurance companies. The purpose of the policy is to bring transparency to health care costs in order to increase competition and lower costs. 

“This court decision gives us a real path forward to getting rid of secret contracts and pushing the power down to the consumer to make informed decisions when purchasing health care,” said Treasurer Folwell. “Health care is the only thing in your life that you purchase that you really don’t know its cost or value. Having clear pricing will go a long way toward decreasing the cost of medical services in this country.” 

The administration’s policy was announced in June of 2019. It was immediately challenged by the American Hospital Association, which argued that the rule violated the First Amendment and went beyond the statutory provisions of the Affordable Care Act.  

However, in June the trade association lost its case before a federal judge in the District of Columbia and, last week, it also lost before the U.S. Court of Appeals in the District of Columbia. The new rules went into effect Jan. 1. 

Treasurer Folwell and the State Health Plan (SHP) have similarly sought to bring transparency to medical pricing through the Clear Pricing Project (CPP). Announced in 2018, the initiative will move away from a commercial-based payment model to a reference-based, transparent pricing model tied to Medicare rates. The new network, known as the North Carolina State Health Plan Network (Network), currently consists of more than 26,000 health care professionals who want to change the secretive nature of medical pricing. 

SHP members are being encouraged to use CPP providers. The SHP Board of Trustees approved 2021 SHP-design changes that highlight CPP providers as those who support transparency and affordable health care. Members will reap the benefits of these changes as they will be able to visit a CPP Primary Care Provider for a $0 copay, compared to the current copay of up to $45, and a CPP Specialist for as little as $40, compared to the current copay of $80 to $94. 

“We want to encourage our members to use CPP providers. People need to know what they’re actually paying for health care,” said Treasurer Folwell. “We cannot continue to spend trillions of dollars on something that we have no idea what it costs. The state and the country can’t afford it. Those that oppose medical price transparency will be on the wrong side of history.” 

Treasurer Folwell cited UNC Healthcare’s new online feature that gives patients a real-time estimate on a number of different procedures and office visits as a “step in the right direction” to increasing transparency in medical pricing. He added that he looks forward to seeing how the tool works and to collaborating with those that want real change in how medical services are provided and paid for.    

The SHP, a division of the N.C. Department of State Treasurer, provides health care coverage to  nearly 750,000 teachers, current and former lawmakers, state university and community college personnel, active and retired state employees, and their dependents. For more information, visit the SHP website .