Gayle recently talked with Leo Wisneiwski, founder of Health Cost Labs (www.healthcostlabs.com) about hospital price transparency and how this newly disclosed data will be a game changer for health care expenditures.
Leo described how his experiences with fee schedules and billing data at an insurer lead him to found a company that cleans hospital price data and makes it usable for brokers, employers and patients. When insurers change fee schedules, providers respond by billing the same procedure with different codes to maximize revenue. Insurers claim they are controlling costs, but the data does not support this claim. Leo says this lack of empathy for patients who cannot afford care drives him to make the data available so people can shop for value and hold insurance companies and providers accountable.
Health Cost Labs data is available for purchase by state and more hospitals are releasing their pricing data every week. So far, many of the Health Cost Labs customers are brokers who want to help employer groups save on hospital expenditures.
Leo talked about the new fiduciary requirements that go into effect in 2022 that require employers to act on this sort of price data. And uninsured patients will have new protections in 2022 as bills too far in excess of the good faith estimate will be arbitrated.
Since Leo has an actuarial background, Gayle wanted to know his view of whether actuaries are doing as much as they should to address dysfunctions in the healthcare system. Leo believes most actuaries are entrenched in their bubble; they trend and risk adjust but they don’t embrace broad price transparency efforts. He says there’s apathy about the system from middlemen, whether it’s actuaries or other leaders in managed care; if there’s always a buyer for my services, I don’t actually need to do anything about spending. Gayle and Leo touched on the importance of bottom-up empowerment and mindset in improving the results we see in healthcare. And Leo warned that he sees a day of reckoning coming for the high cost players. It will be exciting to see what happens as more people use newly disclosed hospital price data in 2022.
Gayle recently talked with Leo Wisneiwski, founder of Health Cost Labs (www.healthcostlabs.com) about hospital price transparency and how this newly disclosed data will be a game changer for health care expenditures.
Leo described how his experiences with fee schedules and billing data at an insurer lead him to found a company that cleans hospital price data and makes it usable for brokers, employers and patients. When insurers change fee schedules, providers respond by billing the same procedure with different codes to maximize revenue. Insurers claim they are controlling costs, but the data does not support this claim. Leo says this lack of empathy for patients who cannot afford care drives him to make the data available so people can shop for value and hold insurance companies and providers accountable.
Health Cost Labs data is available for purchase by state and more hospitals are releasing their pricing data every week. So far, many of the Health Cost Labs customers are brokers who want to help employer groups save on hospital expenditures.
Leo talked about the new fiduciary requirements that go into effect in 2022 that require employers to act on this sort of price data. And uninsured patients will have new protections in 2022 as bills too far in excess of the good faith estimate will be arbitrated.
Since Leo has an actuarial background, Gayle wanted to know his view of whether actuaries are doing as much as they should to address dysfunctions in the healthcare system. Leo believes most actuaries are entrenched in their bubble; they trend and risk adjust but they don’t embrace broad price transparency efforts. He says there’s apathy about the system from middlemen, whether it’s actuaries or other leaders in managed care; if there’s always a buyer for my services, I don’t actually need to do anything about spending. Gayle and Leo touched on the importance of bottom-up empowerment and mindset in improving the results we see in healthcare. And Leo warned that he sees a day of reckoning coming for the high cost players. It will be exciting to see what happens as more people use newly disclosed hospital price data in 2022.